Provider Demographics
NPI: | 1912289042 |
---|---|
Name: | ALL CARE MEDICAL CONSULTANTS, PA |
Entity type: | Organization |
Organization Name: | ALL CARE MEDICAL CONSULTANTS, PA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO/PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | M |
Authorized Official - Middle Name: | I |
Authorized Official - Last Name: | YAMANI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 727-587-0377 |
Mailing Address - Street 1: | 1745 S HIGHLAND AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | CLEARWATER |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33756-1852 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 727-587-0377 |
Mailing Address - Fax: | 727-587-0527 |
Practice Address - Street 1: | 1745 S HIGHLAND AVE |
Practice Address - Street 2: | |
Practice Address - City: | CLEARWATER |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33756-1852 |
Practice Address - Country: | US |
Practice Address - Phone: | 727-587-0377 |
Practice Address - Fax: | 727-587-0527 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-09-14 |
Last Update Date: | 2011-09-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332900000X | Suppliers | Non-Pharmacy Dispensing Site |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | K3710 | Medicare PIN |