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General NPI Number Information
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NPI Number | 1235882895
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Entity Type | Organization
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Legal Business Name | DEDICATED SENIOR MEDICAL CENTERS OF FLORIDA, LLC
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 4650 S CLEVELAND AVE # 15A
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City | FORT MYERS
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State | FL
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Zip | 33907-1309
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Country | US
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Telephone | 239-689-7411
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Fax | 239-766-7753
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Provider Business Mailing Address
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Address Line | 1395 NW 167TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-5710
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Country | US
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Telephone | 305-628-6117
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MARY CHEN
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Credential |
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Telephone | 305-628-6117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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