Provider Demographics
NPI:1730473513
Name:NPS PROFESSIONAL CARE CORP
Entity Type:Organization
Organization Name:NPS PROFESSIONAL CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-419-8141
Mailing Address - Street 1:8807 NW 109TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4547
Mailing Address - Country:US
Mailing Address - Phone:305-823-6894
Mailing Address - Fax:305-823-6894
Practice Address - Street 1:2740 SW 97TH AVE
Practice Address - Street 2:111-112
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2681
Practice Address - Country:US
Practice Address - Phone:305-222-6002
Practice Address - Fax:305-222-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9268126261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service