Basic Information
| Provider Information | |||||||||
| NPI: | 1821519703 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARTNERS IN INTEGRATED CARE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6101 BLUE LAGOON DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331262051 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865523143 | ||||||||
| FaxNumber: | 3053706181 | ||||||||
| Practice Location | |||||||||
| Address1: | 2131 N STATE ROAD 7 | ||||||||
| Address2: | |||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330635713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549745400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2017 | ||||||||
| LastUpdateDate: | 10/16/2017 | ||||||||
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| AuthorizedOfficialLastName: | MCCORMICK | ||||||||
| AuthorizedOfficialFirstName: | JIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | REGIONAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3055502000 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PARTNERS IN INTEGRATED CARE, INC. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | FL | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.