Basic Information
| Provider Information | |||||||||
| NPI: | 1376902965 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPS MEDICAL MANAGEMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 W HILLSBORO BLVD | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334421484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544283500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3501 WEST DR | ||||||||
| Address2: | SUITE B | ||||||||
| City: | DEERFIELD BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334422000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544261000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2016 | ||||||||
| LastUpdateDate: | 02/11/2016 | ||||||||
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| AuthorizedOfficialLastName: | VEGA | ||||||||
| AuthorizedOfficialFirstName: | FRANCIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 9544283500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP9330507 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.