Provider Demographics
NPI:1538359278
Name:CAREIQ
Entity type:Organization
Organization Name:CAREIQ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BRANCH MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEJANOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-744-5678
Mailing Address - Street 1:2020 NW 150TH AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2805
Mailing Address - Country:US
Mailing Address - Phone:954-744-5674
Mailing Address - Fax:866-432-0593
Practice Address - Street 1:2020 NW 150TH AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2805
Practice Address - Country:US
Practice Address - Phone:954-744-5674
Practice Address - Fax:866-432-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QR0200X305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization