Provider Demographics
NPI:1184806168
Name:SENIOR MEDICAL CARE I LLC
Entity type:Organization
Organization Name:SENIOR MEDICAL CARE I LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-558-7563
Mailing Address - Street 1:2035 HARDING ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2714
Mailing Address - Country:US
Mailing Address - Phone:954-212-6701
Mailing Address - Fax:954-212-6702
Practice Address - Street 1:2035 HARDING ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2714
Practice Address - Country:US
Practice Address - Phone:954-212-6701
Practice Address - Fax:954-212-6702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIOR MEDICAL CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68-4515Medicare PIN