Healthcare Provider Details
I. General information
NPI: 1154858538
Provider Name (Legal Business Name): ASSOCIATES IN FAMILY PRACTICE OF BROWARD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2017
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2004 N FLAMINGO RD
PEMBROKE PINES FL
33028
US
IV. Provider business mailing address
4780 SW 64TH AVE STE 103
DAVIE FL
33314-4400
US
V. Phone/Fax
- Phone: 954-450-8500
- Fax:
- Phone: 954-434-1705
- Fax: 800-642-2398
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUIS
FELIPE
LAFRATTA
Title or Position: CEO
Credential:
Phone: 954-279-2572