Provider Demographics
NPI:1609203579
Name:AMERICAN CARE OF SOUTH FLORIDA, INC.
Entity Type:Organization
Organization Name:AMERICAN CARE OF SOUTH FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-278-0200
Mailing Address - Street 1:11255 SW 211TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2240
Mailing Address - Country:US
Mailing Address - Phone:305-278-0200
Mailing Address - Fax:786-235-0145
Practice Address - Street 1:3342 BROADWAY
Practice Address - Street 2:SUITE A
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-2328
Practice Address - Country:US
Practice Address - Phone:561-249-4409
Practice Address - Fax:561-909-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53888208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME53888OtherMEDICAL LICENSE