Organization
INTENSIVE CARE CONSORTIUM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA GOMEZ (CREDENTIALING)
(786) 621-3897
Entity
Organization
Contact information
Practice address
13001 SOUTHERN BLVD, LOXAHATCHEE, FL 33470-9203
(954) 224-9029
(786) 621-3897
Mailing address
13001 SOUTHERN BLVD, LOXAHATCHEE, FL 33470-9203
(954) 224-9029
(786) 621-3897
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
FL
Other
Enumeration date
08/07/2008
Last updated
08/07/2008
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