Basic Information
| Provider Information | |||||||||
| NPI: | 1245584200 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPS MEDICAL MANAGEMENT, LLC | ||||||||
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| OtherOrganizationName: | UNIMED HEALTH SYSTEMS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 W HILLSBORO BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334421484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544283500 | ||||||||
| FaxNumber: | 9544280839 | ||||||||
| Practice Location | |||||||||
| Address1: | 750 E SAMPLE RD | ||||||||
| Address2: | BLDG 3, BAY 6 | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330645144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549438737 | ||||||||
| FaxNumber: | 9549431358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2012 | ||||||||
| LastUpdateDate: | 10/30/2012 | ||||||||
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| AuthorizedOfficialLastName: | VEGA | ||||||||
| AuthorizedOfficialFirstName: | FRANCIS | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR, OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 9544283500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | ARNP9278137 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.