Healthcare Provider Details
I. General information
NPI: 1386176295
Provider Name (Legal Business Name): PRIORITY 1 MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2017
Last Update Date: 03/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 N FEDERAL HWY STE 201
POMPANO BEACH FL
33062-1022
US
IV. Provider business mailing address
2000 N FEDERAL HWY STE 201
POMPANO BEACH FL
33062-1022
US
V. Phone/Fax
- Phone: 561-618-8001
- Fax: 954-960-5642
- Phone: 561-618-8001
- Fax: 954-960-5642
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME14359 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME42167 |
| License Number State | FL |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0000X |
| Taxonomy | Adolescent Medicine (Internal Medicine) Physician |
| License Number | ME42167 |
| License Number State | FL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0401X |
| Taxonomy | Addiction Medicine (Internal Medicine) Physician |
| License Number | ME42167 |
| License Number State | FL |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | ACN97 |
| License Number State | FL |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME14359 |
| License Number State | FL |
VIII. Authorized Official
Name: MS.
ANNA
J
CUARTAS
Title or Position: MANAGER
Credential:
Phone: 561-618-8001