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General NPI Number Information
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NPI Number | 1538424122
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Entity Type | Organization
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Legal Business Name | MEMORIAL HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 801 N FLAMINGO RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1046
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Country | US
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Telephone | 954-844-6868
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Fax | 954-443-4747
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Provider Business Mailing Address
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Address Line | 801 N FLAMINGO RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1046
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Country | US
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Telephone | 954-844-6868
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Fax | 954-443-4747
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Authorized Official
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Title or Position | ARNP
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Name | MRS. OLEINE JULES
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Credential | ARNP
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Telephone | 954-844-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 3265412
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License Number State | FL
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