Provider Demographics
NPI:1508278029
Name:MULTI CARE MEDICAL, LLC
Entity Type:Organization
Organization Name:MULTI CARE MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GELCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-441-7246
Mailing Address - Street 1:11270 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4101
Mailing Address - Country:US
Mailing Address - Phone:954-441-7246
Mailing Address - Fax:954-441-7241
Practice Address - Street 1:11270 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4101
Practice Address - Country:US
Practice Address - Phone:954-441-7246
Practice Address - Fax:954-441-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6925111NR0400X
GAMD052073261QM2500X
FLDPT24946261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFC296ZMedicare PIN
GAH11234Medicare PIN
FL55314Medicare PIN