Provider Demographics
NPI:1093531691
Name:TEAM CARE MEDICAL PLLC
Entity type:Organization
Organization Name:TEAM CARE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REVENUE AND FINANCE OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HORMAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-837-1601
Mailing Address - Street 1:13665 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:596 PROSPECT PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4205
Practice Address - Country:US
Practice Address - Phone:833-252-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care