Provider Demographics
NPI:1114923075
Name:PROMPTCARE FLORIDA, INC.
Entity type:Organization
Organization Name:PROMPTCARE FLORIDA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LARIVIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-776-6782
Mailing Address - Street 1:3402 SW 26TH TER STE B03
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5071
Mailing Address - Country:US
Mailing Address - Phone:954-923-4693
Mailing Address - Fax:954-923-4699
Practice Address - Street 1:3402 SW 26TH TER STE B03
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-5071
Practice Address - Country:US
Practice Address - Phone:954-923-4693
Practice Address - Fax:954-923-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027214100Medicaid
FLM0060OtherINSURANCE
FLM0060OtherINSURANCE