Provider Demographics
NPI:1699070367
Name:SUPERIOR PATIENT CARE,INC
Entity type:Organization
Organization Name:SUPERIOR PATIENT CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIELKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYORGA
Authorized Official - Suffix:
Authorized Official - Credentials:MASSAGE THERAPIST
Authorized Official - Phone:786-431-5181
Mailing Address - Street 1:6781 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2923
Mailing Address - Country:US
Mailing Address - Phone:786-431-5181
Mailing Address - Fax:786-431-5481
Practice Address - Street 1:6781 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2923
Practice Address - Country:US
Practice Address - Phone:786-431-5181
Practice Address - Fax:786-431-5481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8817261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC8817OtherAGENCY FOR HEALTH CARE ADMINISTRATION