Healthcare Provider Details

I. General information

NPI: 1215988837
Provider Name (Legal Business Name): UNITED SERVICES OF SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 E COMMERCIAL BLVD SUITE 308
FT LAUDERDALE FL
33308-3763
US

IV. Provider business mailing address

2021 E COMMERCIAL BLVD SUITE 308
FT LAUDERDALE FL
33308-3763
US

V. Phone/Fax

Practice location:
  • Phone: 954-202-6599
  • Fax: 305-476-5752
Mailing address:
  • Phone: 954-202-6599
  • Fax: 305-476-5752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS 6254
License Number StateFL

VIII. Authorized Official

Name: MR. NELSON ALVAREZ
Title or Position: VICE PRESIDENT
Credential:
Phone: 954-202-6599