Provider Demographics
NPI:1164851028
Name:PROFESSIONAL CASE MANAGEMENT SERVICES CORP
Entity Type:Organization
Organization Name:PROFESSIONAL CASE MANAGEMENT SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-319-7260
Mailing Address - Street 1:175 FONTAINEBLEAU BLVD STE 2J3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4511
Mailing Address - Country:US
Mailing Address - Phone:786-319-7260
Mailing Address - Fax:
Practice Address - Street 1:175 FONTAINEBLEAU BLVD STE 2J3
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4511
Practice Address - Country:US
Practice Address - Phone:786-319-7260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management