Provider Demographics
NPI:1467040519
Name:TRUCARE MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:TRUCARE MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GIEZY
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-533-8353
Mailing Address - Street 1:201 NW 82ND AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1855
Mailing Address - Country:US
Mailing Address - Phone:954-533-8353
Mailing Address - Fax:954-533-8230
Practice Address - Street 1:201 NW 82ND AVE STE 305
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1855
Practice Address - Country:US
Practice Address - Phone:954-533-8353
Practice Address - Fax:954-533-8230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty