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General NPI Number Information
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NPI Number | 1396139150
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Entity Type | Organization
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Legal Business Name | HOLLYWOOD PRIMARY CARE
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 12/26/2019
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Provider Practice Location Address
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Address Line | 2301 N UNIVERSITY DR STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3617
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Country | US
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Telephone | 954-271-7180
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Fax | 954-900-8869
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Provider Business Mailing Address
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Address Line | 2301 N UNIVERSITY DR STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3617
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Country | US
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Telephone | 954-271-7180
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Fax | 954-900-8869
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANCIS SALAZAR
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Credential | DO
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Telephone | 954-271-7180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | OS10490
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | OS10490
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | OS10490
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License Number State | FL
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