Healthcare Provider Details

I. General information

NPI: 1548587447
Provider Name (Legal Business Name): APEX SOUTH FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2010
Last Update Date: 05/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W OAKLAND PARK BLVD SUITE 315
OAKLAND PARK FL
33311-1388
US

IV. Provider business mailing address

2701 W OAKLAND PARK BLVD SUITE 315
OAKLAND PARK FL
33311-1388
US

V. Phone/Fax

Practice location:
  • Phone: 954-484-0300
  • Fax:
Mailing address:
  • Phone: 954-484-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME 55294
License Number StateFL

VIII. Authorized Official

Name: WILLIAM STEVE HASTON
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 954-484-0300