Provider Demographics
NPI:1790976041
Name:PENTACARE HEALTH NETWORK CORP
Entity Type:Organization
Organization Name:PENTACARE HEALTH NETWORK CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT/ADMINISTRATOR ALTERNA
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:F
Authorized Official - Last Name:CABREJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-263-4023
Mailing Address - Street 1:7105 SW 8TH ST STE 303
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4664
Mailing Address - Country:US
Mailing Address - Phone:305-263-4023
Mailing Address - Fax:305-264-4023
Practice Address - Street 1:7105 SW 8TH ST STE 303
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4664
Practice Address - Country:US
Practice Address - Phone:305-263-4023
Practice Address - Fax:305-264-4023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992549251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health