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General NPI Number Information
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NPI Number | 1144940396
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Entity Type | Organization
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Legal Business Name | BLUE RIBBON MEDICAL CLINIC GROUP
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 2310 NW 3RD AVE STE 3
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City | POMPANO BEACH
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State | FL
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Zip | 33060-4963
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Country | US
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Telephone | 617-936-9525
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Fax |
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Provider Business Mailing Address
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Address Line | 2310 NW 3RD AVE STE 3
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City | POMPANO BEACH
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State | FL
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Zip | 33060-4963
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Country | US
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Telephone | 617-936-9525
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | ROBESPIERRE LAFLEUR
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Credential |
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Telephone | 561-767-1908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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