Healthcare Provider Details
I. General information
NPI: 1356537385
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2007
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6521 N ANDREWS AVE
FT LAUDERDALE FL
33309-2131
US
IV. Provider business mailing address
5080 SPECTRUM DR STE. 1200 WEST TOWER
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 954-229-7417
- Fax: 954-229-7451
- Phone: 800-232-3550
- Fax: 800-401-6728
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
G
HASSETT
Title or Position: VP
Credential:
Phone: 972-364-8000