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General NPI Number Information
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NPI Number | 1003300690
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Entity Type | Organization
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Legal Business Name | DOCTOR'S MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 6244 W OAKLAND PARK BLVD
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City | SUNRISE
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State | FL
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Zip | 33313-1214
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Country | US
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Telephone | 754-216-2715
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Fax | 954-697-0842
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Provider Business Mailing Address
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Address Line | 6244 W OAKLAND PARK BLVD
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City | SUNRISE
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State | FL
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Zip | 33313-1214
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Country | US
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Telephone | 754-216-2715
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Fax | 954-697-0842
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JACQUELINE DAVID
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Credential | DO
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Telephone | 954-562-5541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS11008
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License Number State | FL
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