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General NPI Number Information
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NPI Number | 1386944189
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Entity Type | Organization
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Legal Business Name | DOCTORS MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 501 NW 179TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2807
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Country | US
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Telephone | 954-608-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 501 NW 179TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2807
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Country | US
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Telephone | 954-608-4140
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLOS PEREZ
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Credential |
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Telephone | 954-608-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State | FL
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