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General NPI Number Information
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NPI Number | 1356750947
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Entity Type | Organization
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Legal Business Name | TRAPEX MEDICAL CENTER, INC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 2701 W OAKLAND PARK BLVD SUITE 103
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1388
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Country | US
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Telephone | 954-533-1165
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Fax | 954-533-1507
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Provider Business Mailing Address
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Address Line | 2701 W OAKLAND PARK BLVD SUITE 103
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City | OAKLAND PARK
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State | FL
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Zip | 33311-1388
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Country | US
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Telephone | 954-533-1165
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Fax | 954-533-1507
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. NIRVA DERIZIER
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Credential | M.D.
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Telephone | 954-533-1165
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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 | ME60805
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License Number State | FL
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