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General NPI Number Information
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NPI Number | 1447465547
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Entity Type | Organization
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Legal Business Name | BROWARD MEDICAL & URGENT CARE INC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 103 SE 20TH ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2846
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Country | US
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Telephone | 954-462-7558
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Fax | 954-525-5820
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Provider Business Mailing Address
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Address Line | 103 SE 20TH ST SUITE 100
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2846
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Country | US
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Telephone | 954-462-7558
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Fax | 954-525-5820
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MARTIN M ROCHE
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Credential | MD
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Telephone | 954-462-7558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME13408
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | ME13408
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License Number State | FL
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