Basic Information
| Provider Information | |||||||||
| NPI: | 1336574011 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GUIDANCE/CARECENT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99198 OVERSEAS HWY STE 3 | ||||||||
| Address2: | |||||||||
| City: | KEY LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330372437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054347660 | ||||||||
| FaxNumber: | 3054518019 | ||||||||
| Practice Location | |||||||||
| Address1: | 99198 OVERSEAS HWY STE 3 | ||||||||
| Address2: | |||||||||
| City: | KEY LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330372437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054347660 | ||||||||
| FaxNumber: | 3054518019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2013 | ||||||||
| LastUpdateDate: | 09/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | WHEELER | ||||||||
| AuthorizedOfficialFirstName: | TIFFANY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CASEMANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3054347660 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | Y | Managed Care Organizations | Health Maintenance Organization |
No ID Information.