Provider Demographics
NPI:1679594717
Name:INCARE MEDICAL SERVICES
Entity type:Organization
Organization Name:INCARE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-775-6455
Mailing Address - Street 1:11865 US HIGHWAY 1
Mailing Address - Street 2:SUITE B
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2848
Mailing Address - Country:US
Mailing Address - Phone:561-775-6455
Mailing Address - Fax:561-775-6456
Practice Address - Street 1:5216 MISTY MORN RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-7824
Practice Address - Country:US
Practice Address - Phone:561-881-9995
Practice Address - Fax:561-881-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0075721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78605WMedicare ID - Type Unspecified
FL14665UMedicare ID - Type Unspecified
FLU0006AMedicare ID - Type Unspecified