Provider Demographics
NPI:1407074230
Name:SPECIALIZED ON-SITE CARE MANAGEMENT, INC.
Entity Type:Organization
Organization Name:SPECIALIZED ON-SITE CARE MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-648-1940
Mailing Address - Street 1:6100 BLUE LAGOON DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2079
Mailing Address - Country:US
Mailing Address - Phone:305-648-1940
Mailing Address - Fax:305-648-3279
Practice Address - Street 1:6100 BLUE LAGOON DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2079
Practice Address - Country:US
Practice Address - Phone:305-648-1940
Practice Address - Fax:305-648-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty