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General NPI Number Information
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NPI Number | 1710748199
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Entity Type | Organization
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Legal Business Name | AZULLA COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 8304 W OAKLAND PARK BLVD
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City | SUNRISE
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State | FL
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Zip | 33351-7308
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Country | US
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Telephone | 561-725-4971
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Fax | 561-855-8872
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Provider Business Mailing Address
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Address Line | 2677 FOREST HILL BLVD STE 125
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City | PALM SPRINGS
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State | FL
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Zip | 33406-5941
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Country | US
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Telephone | 561-725-4971
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VENTRICIA HARRIS-VICTOR
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Credential | DNP, FNP-C
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Telephone | 561-401-8018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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