Provider Demographics
NPI:1679212591
Name:TERRA CARE
Entity Type:Organization
Organization Name:TERRA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGANYUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-697-2520
Mailing Address - Street 1:1899 NE 164TH ST # 2
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4109
Mailing Address - Country:US
Mailing Address - Phone:305-697-2520
Mailing Address - Fax:
Practice Address - Street 1:1899 NE 164TH ST # 2
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4109
Practice Address - Country:US
Practice Address - Phone:305-697-2520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies