NPIMap

Organization Active NPI

Provident Care Management

  • Case Management Agency
  • Tamarac, FL
National Provider Identifier
1073757423
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PROVIDENT CARE MANAGEMENT
Practice address
6412 N University Dr
Suite 120
Tamarac, FL 33321-4055
Phone
(954) 726-7267
Fax
(954) 726-7776
NPI assigned
Apr 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lori E. Kobetz
Title
Manager
Phone
(954) 294-5244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

6412 N University Dr
Suite 120
Tamarac, FL 33321-4055

Mailing address

6412 North University Drive
Suite 120
Tamarac, FL 33321-5568
Phone (954) 726-7267

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1073757423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 NORTH UNIVERSITY DRIVE",
            "address_2": "SUITE 120",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333215568",
            "telephone_number": "954-726-7267",
            "fax_number": "954-726-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 N UNIVERSITY DR",
            "address_2": "SUITE 120",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333214055",
            "telephone_number": "954-726-7267",
            "fax_number": "954-726-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT CARE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "KOBETZ",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-294-5244",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.