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General NPI Number Information
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NPI Number | 1134535891
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Entity Type | Organization
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Legal Business Name | INDEPENDENT FAMILY PRACTICE CORPORATION
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 17500 NE 9TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-2123
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Country | US
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Telephone | 518-813-0007
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Fax | 425-871-0007
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Provider Business Mailing Address
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Address Line | 17500 NE 9TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-2123
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Country | US
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Telephone | 518-813-0007
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Fax | 425-871-0007
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH TEMPELBERG
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Credential |
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Telephone | 518-813-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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