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General NPI Number Information
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NPI Number | 1093084014
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Entity Type | Organization
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Legal Business Name | PREVENTIVE MEDICINE ASSOCIATES LLC
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Dates
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Enumeration Date | 12/20/2011
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 4800 SW 198TH TER
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33332-1135
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Country | US
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Telephone | 954-600-9047
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 SW 198TH TER
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33332-1135
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Country | US
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Telephone | 954-600-9047
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Fax |
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Authorized Official
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Title or Position | DR
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Name | DR. CURTIS ERWIN WILKINSON
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Credential | DO
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Telephone | 954-600-9047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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