THE SOURCE FL PROFESSIONAL SERVICES, LLC (NPI# 1588215784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588215784 |
| Entity Type | Organization |
| Organization Name | THE SOURCE FL PROFESSIONAL SERVICES, LLC |
| Practice Address |
1730 E Commercial Blvd Oakland Park FL 33334-5721 |
| Practice Telephone | 9542882555 |
| Mailing Telephone | 9542882555 |
| Enumeration Date | 2019-09-28 |
| Last Update Date | 2019-11-22 |
| Authorized Official Name | MARK J KORCOK (PRESIDENT) |
| Authorized Official Telephone | 9542882555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
1730 E COMMERCIAL BLVD |
| City | OAKLAND PARK |
| State | FL |
| Zip Code | 33334-5721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083111827 | The Source Fl | Substance Abuse Rehabilitation Facility | 1730 E Commercial Blvd, Oakland Park, FL 33334-5721 | 2018-04-09 |
| 1679124879 | Addictions Behavioral Health Center of America Professional Group, LLC | General Practice | 1730 E Commercial Blvd, Oakland Park, FL 33334-5721 | 2019-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245755644 | Fusion Health & Wellness LLC | Counselor | 1164 E Oakland Park Blvd Ste 102, Oakland Park, FL 33334 | 2017-08-07 |
| 1376064063 | The Senior Spot | Custodial Care Facility | 410 E Oakland Park Blvd., Wilton Manors, FL 33334 | 2017-07-03 |
| 1952831810 | Andrew Morgan | Counselor | 450 Ne 44th Street, Oakland Park, FL 33334 | 2017-06-14 |
| 1033561907 | Trevor Howe Hart | Dentist | 3425 N Dixie Hwy, Oakland Park, FL 33334 | 2016-07-05 |
| 1548646698 | Shelly Vilsaint | Massage Therapist | 120 E. Oakland Park Blvd, Suite 208, Fort Lauderdale, FL 33334 | 2015-07-30 |
| 1295129641 | Kristin Joann Biggie | Pediatrics | 5333 N Dixie Highway, Suite 106, Fort Lauderdale, FL 33334 | 2015-03-24 |
| 1235529116 | Rodolfo Herrera Barter | General Practice | 735 E Oakland Park Blvd, Oakland Park, FL 33334 | 2015-01-29 |
| 1639573629 | Garrick Edwards | Health Educator | 1501 Ne 62nd Street, Ft. Lauderdale, FL 33334 | 2014-10-20 |
| 1568877967 | Michael James Breen Jr. | Occupational Therapist | 1000 Corporate Dr #280, Centra Healthcare, Fort Lauderdale, FL 33334 | 2014-06-24 |
| 1144649161 | Passage Health International | Case Management | 701 E Commercial Blvd Fl 4, Oakland Park, FL 33334 | 2014-04-08 |
| Find all providers in zip 33334 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235529116 | Rodolfo Herrera Barter | General Practice | 735 E Oakland Park Blvd, Oakland Park, FL 33334 | 2015-01-29 |
| 1104810399 | Leovigildo J Reyes | General Practice | 4401 N Andrews Ave, Oakland Park, FL 33309 | 2005-09-02 |
| 1295351831 | Carewell Mobile LLC | General Practice | 1754 E Commercial Blvd, Oakland Park, FL 33334-5721 | 2020-06-19 |
| 1679124879 | Addictions Behavioral Health Center of America Professional Group, LLC | General Practice | 1730 E Commercial Blvd, Oakland Park, FL 33334-5721 | 2019-09-28 |
| 1285298836 | Apex Medical Centers LLC | General Practice | 2764 W Oakland Park Blvd, Oakland Park, FL 33311-1336 | 2019-04-30 |
| 1801340641 | Adriana Maria Aristizabal | General Practice | 1400 E Oakland Park Blvd Ste 210, Oakland Park, FL 33334 | 2016-08-10 |
| 1790150217 | Ab Total Health | General Practice | 4401 N Andrews Ave, Oakland Park, FL 33309-3917 | 2015-12-09 |
| 1487097143 | American Care of South Florida, Inc. | General Practice | 1600 W Oakland Park Blvd, Suite A, Oakland Park, FL 33311-1520 | 2013-04-12 |
| 1497012819 | Invesclinic | General Practice | 4401 N Andrews Ave, Oakland Park, FL 33309-3917 | 2012-04-23 |
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|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | OAKLAND PARK |
| Zip Code | 33334 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.