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General NPI Number Information
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NPI Number | 1174062566
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Entity Type | Organization
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Legal Business Name | FORT LAUDERDALE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 4825 N DIXIE HWY
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3928
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Country | US
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Telephone | 754-900-2410
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Fax | 954-840-8254
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Provider Business Mailing Address
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Address Line | 4825 N DIXIE HWY
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3928
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Country | US
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Telephone | 754-900-2410
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Fax | 954-840-8254
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN C MONACO
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Credential | OWNER
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Telephone | 754-900-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT17639
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License Number State | FL
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