MEDICARE: SOUTH FLORIDA OCCUPATIONAL MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center	ME81042	FL

General Provider Information

NPI Number	:	1275867392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH FLORIDA OCCUPATIONAL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	14201 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-7224
Country	:	US
Telephone Number	:	786-242-2479
Fax Number	:	786-242-3982

Provider Business Practice Location Address
First Line	:	14201 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-7224
Country	:	US
Telephone Number	:	786-242-2479
Fax Number	:	786-242-3982

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. HOSSEIN JOUKAR
Credential	:	M.D.
Telephone Number	:	786-242-2479

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	09/22/2009

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