Provider Demographics
NPI:1639734148
Name:MANAGEMENT CARE LLC
Entity Type:Organization
Organization Name:MANAGEMENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-549-3309
Mailing Address - Street 1:7900 NW 33RD ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2209
Mailing Address - Country:US
Mailing Address - Phone:954-962-5300
Mailing Address - Fax:954-962-0100
Practice Address - Street 1:7900 NW 33RD ST STE 103
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2209
Practice Address - Country:US
Practice Address - Phone:954-962-5300
Practice Address - Fax:954-962-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL574156531Medicaid