Healthcare Provider Details
I. General information
NPI: 1932381639
Provider Name (Legal Business Name): FLORIDA MEDICAL PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
603 N FLAMINGO RD SUITE 150
PEMBROKE PINES FL
33028-1023
US
IV. Provider business mailing address
603 N FLAMINGO RD SUITE 150
PEMBROKE PINES FL
33028-1023
US
V. Phone/Fax
- Phone: 954-436-6660
- Fax: 954-436-6655
- Phone: 954-436-6660
- Fax: 954-436-6655
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MIAN
A
HASAN
Title or Position: PRESIDENT
Credential: MD
Phone: 954-436-6660