Provider Demographics
NPI:1851950869
Name:BIOCORE HEALTH, LLC
Entity Type:Organization
Organization Name:BIOCORE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MOSTEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-430-8765
Mailing Address - Street 1:1009 QUAYE LAKE CIR APT 108
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5075
Mailing Address - Country:US
Mailing Address - Phone:856-430-8765
Mailing Address - Fax:
Practice Address - Street 1:11596 PIERSON RD # 10
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8770
Practice Address - Country:US
Practice Address - Phone:856-430-8765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy