Healthcare Provider Details

I. General information

NPI: 1629833058
Provider Name (Legal Business Name): AMERICAN ACCESS CARE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 W BROWARD BLVD
PLANTATION FL
33324-2701
US

IV. Provider business mailing address

40 VALLEY STREAM PKWY STE 100
MALVERN PA
19355-1407
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-8472
  • Fax:
Mailing address:
  • Phone: 610-644-8900
  • Fax: 484-924-0053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGG MILLER
Title or Position: AUTHORIZED OFFICAL
Credential: MD
Phone: 717-515-4048