Spectrum Life Care Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

228629 Issued in FL

Legal business name

SPECTRUM LIFE CARE SERVICES INC

Practice address

12260 SW 53Rd St Ste 611
Cooper City, FL 33330-3320

Phone

(954) 499-5794

Fax

(954) 309-1520

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Joseph Ciavarella Sr.

Title

President

Phone

(954) 499-5794

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SPECTRUM LIFE CARE Doing business as

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1508989666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12260 SW 53RD ST STE 611",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333303320",
            "telephone_number": "954-499-5794",
            "fax_number": "954-252-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12260 SW 53RD ST STE 611",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333303320",
            "telephone_number": "954-499-5794",
            "fax_number": "954-309-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM LIFE CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-09-08",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "CIAVARELLA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-499-5794",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "228629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681078196",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681078198",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECTRUM LIFE CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SPECTRUM LIFE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Cooper City, FL
• Providers in Cooper City, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.