Healthcare Provider Details

I. General information

NPI: 1437857323
Provider Name (Legal Business Name): SOUTH FLORIDA ADDICTION MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N FEDERAL HWY STE 200
BOCA RATON FL
33432-2813
US

IV. Provider business mailing address

1200 N FEDERAL HWY STE 200
BOCA RATON FL
33432-2813
US

V. Phone/Fax

Practice location:
  • Phone: 561-571-0922
  • Fax: 561-277-0846
Mailing address:
  • Phone: 561-571-0922
  • Fax: 561-277-0846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER ANN POSNER
Title or Position: PROVIDER/OWNER
Credential: PA-C
Phone: 561-571-0922