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Organization

FULL CIRCLE HEALTH CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK SPENCE MD (MEDICAL DIRECTOR)
(305) 693-0000
Entity
Organization

Contact information

Practice address
1190 NW 95TH ST STE 203, MIAMI, FL 33150-2064
(305) 693-0000
(888) 717-7671
Mailing address
1190 NW 95TH ST STE 203, MIAMI, FL 33150-2064
(305) 693-0000
(888) 717-7671

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003574500
FL
01
14C1Y
BLUECROSS & BLUESHIELD
FL
01
174807
STAYWELL/WELLCARE
FL
01
1952313173
NPI
FL
05
255064400
FL
01
43740
BLUECROSS & BLUESHIELD
FL
Enumeration date
08/31/2011
Last updated
11/06/2021
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