Organization
EXTENSIVE SERVICES CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUELA BORCHES (PRESIDENT/ADMINISTRATOR)
(305) 228-1440
Entity
Organization
Contact information
Practice address
2721 SW 137TH AVE STE 107, MIAMI, FL 33175-6355
(305) 228-1440
Mailing address
2721 SW 137TH AVE STE 107, MIAMI, FL 33175-6355
(305) 228-1440
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
HCC8806
FL
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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