MEDICARE: THE CONNECTION FL, LLC

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	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1134527435	OTHER	FL	SELF PAY AND COMMERCIAL INS

General Provider Information

NPI Number	:	1598328577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CONNECTION FL, LLC

Provider Business Mailing Address
First Line	:	2151 E COMMERCIAL BLVD STE 301
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-3807
Country	:	US
Telephone Number	:	954-288-2555
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 E COMMERCIAL BLVD STE 301
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-3807
Country	:	US
Telephone Number	:	954-288-2555
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. MARK KORCOK
Credential	:
Telephone Number	:	954-288-2555

Provider Enumeration Date	:	04/16/2019
Last Update Date	:	04/16/2019

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Directions to “THE CONNECTION FL, LLC ” Practice Location

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