Healthcare Provider Details

I. General information

NPI: 1598789679
Provider Name (Legal Business Name): LAUDERDALE CRITICAL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 N DIXIE HWY SUITE 110
OAKLAND PARK FL
33334-4148
US

IV. Provider business mailing address

6278 N FEDERAL HIGHWAY #374
FT. LAUDERDALE FL
33308
US

V. Phone/Fax

Practice location:
  • Phone: 954-491-3440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RONALD SCOTT
Title or Position: PHYSICIAN
Credential: MD
Phone: 954-908-5895