Provider Demographics
NPI:1780207910
Name:HOMEVILLE MEDICAL CARE
Entity Type:Organization
Organization Name:HOMEVILLE MEDICAL CARE
Other - Org Name:HOMEVILLE MEDICAL CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:786-553-6807
Mailing Address - Street 1:151 N NOB HILL RD # 310
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1708
Mailing Address - Country:US
Mailing Address - Phone:786-553-6807
Mailing Address - Fax:877-935-4207
Practice Address - Street 1:1861 NW 109TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-3417
Practice Address - Country:US
Practice Address - Phone:786-553-6807
Practice Address - Fax:877-935-4207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty