Provider Demographics
NPI:1417169210
Name:INNOVATIVE CARE INC
Entity Type:Organization
Organization Name:INNOVATIVE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GOKHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUVENLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-450-9595
Mailing Address - Street 1:1 SW 129TH AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1761
Mailing Address - Country:US
Mailing Address - Phone:954-450-9595
Mailing Address - Fax:954-450-9774
Practice Address - Street 1:12600 PEMBROKE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2544
Practice Address - Country:US
Practice Address - Phone:954-432-5400
Practice Address - Fax:877-671-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10374207Q00000X
FLME53538207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBF602OtherGROUP MEDICARE #
FLBW654ZOtherDR. MARTINEZ MEDICARE
FLCA283WOtherDR. GUVENLI MEDICARE