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General NPI Number Information
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NPI Number | 1013585868
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Entity Type | Organization
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Legal Business Name | FLORIDA CONCIERGE MEDICINE & WELLNESS LLC
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 5555 HOLLYWOOD BLVD STE 201
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6420
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Country | US
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Telephone | 954-932-3269
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Fax | 954-361-7994
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Provider Business Mailing Address
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Address Line | 5555 HOLLYWOOD BLVD STE 201
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6420
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Country | US
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Telephone | 954-932-3269
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GERARD FRANTZ ACLOQUE JR.
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Credential | MD
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Telephone | 954-932-3269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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