Provider Demographics
NPI:1205962867
Name:FLORIDA HEALTHCARE NETWORK INC
Entity type:Organization
Organization Name:FLORIDA HEALTHCARE NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREDA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:305-274-3311
Mailing Address - Street 1:7860 SW 129TH TER
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6154
Mailing Address - Country:US
Mailing Address - Phone:305-274-3311
Mailing Address - Fax:305-274-1411
Practice Address - Street 1:8585 SUNSET DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3746
Practice Address - Country:US
Practice Address - Phone:305-274-3311
Practice Address - Fax:305-274-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5825Medicare PIN