Provider Demographics
NPI:1336659135
Name:HELIX CARE MANAGEMENT
Entity Type:Organization
Organization Name:HELIX CARE MANAGEMENT
Other - Org Name:HELIX CARE MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-363-3675
Mailing Address - Street 1:7765 NW 48TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5404
Mailing Address - Country:US
Mailing Address - Phone:305-363-3675
Mailing Address - Fax:305-442-2207
Practice Address - Street 1:7765 NW 48TH ST STE 300
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5404
Practice Address - Country:US
Practice Address - Phone:305-363-3675
Practice Address - Fax:305-442-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78770261QI0500X, 302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264910101Medicaid