Healthcare Provider Details

I. General information

NPI: 1750893319
Provider Name (Legal Business Name): TOTAL HEALTH MEDICAL CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 W COMMERCIAL BLVD STE 202
LAUDERHILL FL
33319-2148
US

IV. Provider business mailing address

9737 NW 41ST ST
DORAL FL
33178-2924
US

V. Phone/Fax

Practice location:
  • Phone: 954-748-6665
  • Fax: 954-748-0310
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DEMARQUETTE D KENT
Title or Position: CEO
Credential:
Phone: 502-489-2222