Healthcare Provider Details

I. General information

NPI: 1871246090
Provider Name (Legal Business Name): AMICUS MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1979 W HILLSBORO BLVD STE 1
DEERFIELD BEACH FL
33442-1444
US

IV. Provider business mailing address

1300 CONCORD TER STE 210
SUNRISE FL
33323-2899
US

V. Phone/Fax

Practice location:
  • Phone: 954-428-4800
  • Fax:
Mailing address:
  • Phone: 954-505-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HERIKA MARIE ECHEVARRIA
Title or Position: CREDENTIALING
Credential:
Phone: 954-505-5000