Provider Demographics
NPI:1184048472
Name:INTEGRATED CARE, LLC
Entity type:Organization
Organization Name:INTEGRATED CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:BERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-965-4900
Mailing Address - Street 1:6067 HOLLYWOOD BVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7922
Mailing Address - Country:US
Mailing Address - Phone:954-965-4900
Mailing Address - Fax:954-515-1236
Practice Address - Street 1:21097 NE 27TH COURT
Practice Address - Street 2:SUITE 320
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1206
Practice Address - Country:US
Practice Address - Phone:954-965-4900
Practice Address - Fax:954-515-1236
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRATED CARE, LLD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254534900Medicaid
FLK8345AMedicare PIN
FL254534900Medicaid