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General NPI Number Information
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NPI Number | 1164035861
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Entity Type | Organization
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Legal Business Name | FAMILIA HEALTH CLINIC LLC
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 450 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1604
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Country | US
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Telephone | 954-531-0461
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Fax | 954-531-0713
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Provider Business Mailing Address
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Address Line | 450 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1604
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Country | US
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Telephone | 954-531-0461
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Fax | 954-531-0713
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Authorized Official
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Title or Position | CFO
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Name | ARTHUR SODERBERG
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Credential |
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Telephone | 954-531-0461
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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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