Organization
PROVIDENT CARE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI E. KOBETZ (MANAGER)
(954) 294-5244
Entity
Organization
Contact information
Practice address
6412 N UNIVERSITY DR, SUITE 120, TAMARAC, FL 33321-4055
(954) 726-7267
(954) 726-7776
Mailing address
6412 NORTH UNIVERSITY DRIVE, SUITE 120, TAMARAC, FL 33321-5568
(954) 726-7267
(954) 726-7776
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/29/2009
Last updated
09/29/2010
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