Healthcare Provider Details

I. General information

NPI: 1982244992
Provider Name (Legal Business Name): SNF SOUTH FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6915 S RED RD STE 215A
SOUTH MIAMI FL
33143-3636
US

IV. Provider business mailing address

5660 STRAND CT STE 302
NAPLES FL
34110-3343
US

V. Phone/Fax

Practice location:
  • Phone: 305-231-1204
  • Fax:
Mailing address:
  • Phone: 305-231-1204
  • Fax: 305-901-1482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GHASSAN G HADDAD
Title or Position: OWNER
Credential: MD
Phone: 305-231-1204