Provider Demographics
NPI:1730577727
Name:GPSC MEDICAL CENTERS LLC
Entity type:Organization
Organization Name:GPSC MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CADET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-753-6600
Mailing Address - Street 1:123 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6008
Mailing Address - Country:US
Mailing Address - Phone:305-753-6600
Mailing Address - Fax:786-615-9581
Practice Address - Street 1:123 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6008
Practice Address - Country:US
Practice Address - Phone:305-753-6600
Practice Address - Fax:786-615-9581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 41852261QM1300X
FLME 27293261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL92970OtherMEDICARE IDENTIFICATION NUMBER
FL96208OtherMEDICARE IDENTIFICATION NUMBER
FL037315000Medicaid
FL067559801Medicaid
FL037315000Medicaid
FLD27965Medicare UPIN