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General NPI Number Information
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NPI Number | 1588068100
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Entity Type | Organization
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Legal Business Name | TEAMHEALTH
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 17431 NW 7TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3103
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Country | US
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Telephone | 863-242-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 17431 NW 7TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3103
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Country | US
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Telephone | 863-242-1353
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Fax |
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Authorized Official
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Title or Position | EMERGENCY MEDICINE PHYSICIAN
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Name | DR. ROYNEL GONZALEZ CARRILLO
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Credential | M.D.
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Telephone | 863-242-1353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME108237
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License Number State | FL
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