Healthcare Provider Details

I. General information

NPI: 1376069310
Provider Name (Legal Business Name): DB HEALTH SPECIALTIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2455 HOLLYWOOD BLVD STE 103
HOLLYWOOD FL
33020-6605
US

IV. Provider business mailing address

2455 HOLLYWOOD BLVD STE 103
HOLLYWOOD FL
33020-6605
US

V. Phone/Fax

Practice location:
  • Phone: 954-632-2316
  • Fax: 954-239-3902
Mailing address:
  • Phone: 954-632-2316
  • Fax: 954-239-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID SHORT JR.
Title or Position: PD
Credential:
Phone: 954-632-2316