Organization
INTENSIVE CARE CONSORTIUM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LAVERTY (VICE PRESIDENT)
(615) 507-2312
Entity
Organization
Contact information
Practice address
20900 BISCAYNE BLVD, AVENTURA, FL 33180-1407
(561) 997-0821
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
FL
2086S0102X
Surgical Critical Care Physician
—
—
Other
Enumeration date
08/07/2008
Last updated
09/07/2021
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