Healthcare Provider Details
I. General information
NPI: 1093996977
Provider Name (Legal Business Name): S&W CLINICAL RESEARCH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2007
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2510 E OAKLAND PARK BLVD
FORT LAUDERDALE FL
33306-1601
US
IV. Provider business mailing address
2510 E OAKLAND PARK BLVD
FORT LAUDERDALE FL
33306-1601
US
V. Phone/Fax
- Phone: 954-717-1919
- Fax: 954-717-2528
- Phone: 954-717-1919
- Fax: 954-717-2528
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | OS 2436 |
| License Number State | FL |
VIII. Authorized Official
Name:
ERIC
S
SERFER
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 954-717-1919