| Dlc Professional Care Inc | |
|
3750 W 16th Ave Ste 132u Hialeah FL 33012-4683 | |
| (305) 967-0128 | |
| Not Available |
| Full Name | Dlc Professional Care Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3750 W 16th Ave Ste 132u, Hialeah, Florida |
| Authorized Official Name and Position | Freddy De Las Casas (PRESIDENT) |
| Authorized Official Contact | 3059670128 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dlc Professional Care Inc 3750 W 16th Ave Ste 132u Hialeah FL 33012-4683 Ph: (305) 967-0128 | Dlc Professional Care Inc 3750 W 16th Ave Ste 132u Hialeah FL 33012-4683 Ph: (305) 967-0128 |
| NPI Number | 1700550241 |
|---|---|
| Provider Enumeration Date | 08/08/2021 |
| Last Update Date | 08/08/2021 |
| Certification Date | 08/08/2021 |
| Medicare PECOS PAC ID | 0143616334 |
|---|---|
| Medicare Enrollment ID | O20220418000138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700550241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Freddy De Las Casas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407454838 PECOS PAC ID: 7618365180 Enrollment ID: I20211102003443 |
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