Provider Demographics
NPI:1861847204
Name:SOUTH FLORIDA TRANSITIONAL CARE INC
Entity Type:Organization
Organization Name:SOUTH FLORIDA TRANSITIONAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:OLGA
Authorized Official - Last Name:GARZON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-513-9760
Mailing Address - Street 1:5700 LAKE WORTH RD
Mailing Address - Street 2:SUITE 208-2
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4727
Mailing Address - Country:US
Mailing Address - Phone:561-513-9760
Mailing Address - Fax:561-584-7020
Practice Address - Street 1:5700 LAKE WORTH RD
Practice Address - Street 2:SUITE 208-2
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4727
Practice Address - Country:US
Practice Address - Phone:561-513-9760
Practice Address - Fax:561-584-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3608213ES0103X, 213ES0103X
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDOtherPENDING
FLPENDOtherPENDING