Healthcare Provider Details

I. General information

NPI: 1184232522
Provider Name (Legal Business Name): BUEN PASTOR MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 SHERIDAN ST STE C
HOLLYWOOD FL
33021-3514
US

IV. Provider business mailing address

4400 SHERIDAN ST STE C
HOLLYWOOD FL
33021-3514
US

V. Phone/Fax

Practice location:
  • Phone: 954-882-0191
  • Fax:
Mailing address:
  • Phone: 954-882-0191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIEL G FLOREZ
Title or Position: PRESIDENT
Credential: MD
Phone: 954-882-0191