Healthcare Provider Details

I. General information

NPI: 1083093439
Provider Name (Legal Business Name): TRITON MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 05/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 N UNIVERSITY DR
PEMBROKE PINES FL
33024-5031
US

IV. Provider business mailing address

1114 N UNIVERSITY DR
PEMBROKE PINES FL
33024-5031
US

V. Phone/Fax

Practice location:
  • Phone: 954-552-1839
  • Fax: 954-552-1840
Mailing address:
  • Phone: 954-552-1839
  • Fax: 954-212-5918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARTURO SUAREZ
Title or Position: PRSIDENT
Credential:
Phone: 954-552-1839