Provider Demographics
NPI:1295013563
Name:MED-CARE INFUSION SERVICES, INC.
Entity Type:Organization
Organization Name:MED-CARE INFUSION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES./CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-863-8860
Mailing Address - Street 1:3085 W 80TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-3888
Mailing Address - Country:US
Mailing Address - Phone:305-863-4277
Mailing Address - Fax:305-887-7761
Practice Address - Street 1:8101 W 31ST AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-3890
Practice Address - Country:US
Practice Address - Phone:305-863-4277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH12474332B00000X
FL332BX2000X
FL1314317335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102454000Medicaid
1072242OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL102454000Medicaid