Provider Demographics
NPI:1467824250
Name:C1 MANAGED CARE PARTNERS
Entity Type:Organization
Organization Name:C1 MANAGED CARE PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-703-6065
Mailing Address - Street 1:2400 E COMMERCIAL BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4030
Mailing Address - Country:US
Mailing Address - Phone:954-703-6065
Mailing Address - Fax:888-972-1875
Practice Address - Street 1:2400 E COMMERCIAL BLVD
Practice Address - Street 2:STE 101
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4030
Practice Address - Country:US
Practice Address - Phone:954-703-6065
Practice Address - Fax:888-972-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization