Provider Demographics
NPI:1104441245
Name:OASIS HEALTHCARE
Entity type:Organization
Organization Name:OASIS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERTRUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSELME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-234-4125
Mailing Address - Street 1:765 W PALMETTO PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-3561
Mailing Address - Country:US
Mailing Address - Phone:954-234-4125
Mailing Address - Fax:
Practice Address - Street 1:765 W PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3561
Practice Address - Country:US
Practice Address - Phone:954-234-4125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities