Basic Information
| Provider Information | |||||||||
| NPI: | 1942644661 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ICARE HEALTH SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7352 NW 34TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054182025 | ||||||||
| FaxNumber: | 3054189882 | ||||||||
| Practice Location | |||||||||
| Address1: | 7352 NW 34TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054182025 | ||||||||
| FaxNumber: | 3054189882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2013 | ||||||||
| LastUpdateDate: | 05/09/2013 | ||||||||
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| AuthorizedOfficialLastName: | STERN | ||||||||
| AuthorizedOfficialFirstName: | SIDNEY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3054182025 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302F00000X | Y | Managed Care Organizations | Exclusive Provider Organization |
No ID Information.