MEDICARE: SMARTCARE MEDICAL CENTER 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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1669244539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMARTCARE MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	13049 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4951
Country	:	US
Telephone Number	:	786-306-3767
Fax Number	:	305-899-2049

Provider Business Practice Location Address
First Line	:	1558 NE 162ND ST UNIT B
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4716
Country	:	US
Telephone Number	:	786-306-3767
Fax Number	:

Authorized Official
Title or Position	:	ADMISTRATOR
Name	:	CHANTAL LEMORIN
Credential	:
Telephone Number	:	786-306-3767

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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