Provider Demographics
NPI:1225420649
Name:CHILDREN'S CARE PL
Entity Type:Organization
Organization Name:CHILDREN'S CARE PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:AKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-458-2636
Mailing Address - Street 1:1920 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4722
Mailing Address - Country:US
Mailing Address - Phone:954-458-2636
Mailing Address - Fax:954-458-6979
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 504
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4722
Practice Address - Country:US
Practice Address - Phone:954-458-2636
Practice Address - Fax:954-458-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76672261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255732100Medicaid