Organization
INTENSIVE CARE CONSORTIUM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MOAS (PRESIDENT)
(786) 494-5154
Entity
Organization
Contact information
Practice address
20900 BISCAYNE BLVD, AVENTURA, FL 33180
(561) 997-0821
(561) 997-0849
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 373-7406
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
FL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272561400
—
FL
01
—
97242
BLUE CROSS BLUE SHIELD
FL
01
—
DE6501
RAILROAD MEDICARE
FL
Enumeration date
06/09/2006
Last updated
03/24/2026
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