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General NPI Number Information
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NPI Number | 1538643291
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Entity Type | Organization
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Legal Business Name | FLORIDA PHYSICIANS PSN
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 6000 SW 74 STREET SECOND FLOOR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5068
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Country | US
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Telephone | 305-204-6433
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Fax | 305-330-2486
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Provider Business Mailing Address
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Address Line | 6000 SW 74 STREET SECOND FLOOR
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5068
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Country | US
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Telephone | 305-542-8408
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GEORGE M FERNANDEZ
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Credential |
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Telephone | 305-542-8408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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