MEDICARE: CMA HEALTHCARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	30211377	FL

General Provider Information

NPI Number	:	1588802672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CMA HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	2645 EXECUTIVE PARK DR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3624
Country	:	US
Telephone Number	:	954-641-9586
Fax Number	:	954-337-3322

Provider Business Practice Location Address
First Line	:	2645 EXECUTIVE PARK DR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3624
Country	:	US
Telephone Number	:	954-641-9586
Fax Number	:	954-337-3322

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. CRAIG DONNER
Credential	:	D.C.
Telephone Number	:	954-641-9586

Provider Enumeration Date	:	01/27/2009
Last Update Date	:	09/07/2022

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