Healthcare Provider Details
I. General information
NPI: 1073747721
Provider Name (Legal Business Name): LTC HOSPITALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2009
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 E COMMERCIAL BLVD FL 33308
FORT LAUDERDALE FL
33308-3744
US
IV. Provider business mailing address
PO BOX 636380
CINCINNATI OH
45263-6380
US
V. Phone/Fax
- Phone: 954-771-2300
- Fax:
- Phone: 800-424-3672
- Fax: 954-377-3042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROHIT
UPPAL
Title or Position: PRESIDENT
Credential: MD
Phone: 800-424-3672