Healthcare Provider Details

I. General information

NPI: 1073426458
Provider Name (Legal Business Name): TENET FLORIDA PHYSICIAN SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 CLINT MOORE RD STE 214
BOCA RATON FL
33496-2658
US

IV. Provider business mailing address

1905 CLINT MOORE RD STE 214
BOCA RATON FL
33496-2660
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-6500
  • Fax: 561-912-9556
Mailing address:
  • Phone: 561-967-6500
  • Fax: 561-912-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIAN RASMUS
Title or Position: GOVERNMENT PROGRAM OFFICER AND AO
Credential:
Phone: 469-893-2532