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General NPI Number Information
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NPI Number | 1477047058
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Entity Type | Organization
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Legal Business Name | LATINO MEDICAL CENTER III, INC
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 3670 W OAKLAND BLVD
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311
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Country | US
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Telephone | 954-716-6101
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Fax | 954-533-4634
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Provider Business Mailing Address
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Address Line | 3670 W OAKLAND BLVD
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODNEY JOSEPH
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Credential |
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Telephone | 305-947-4499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | FL
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