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General NPI Number Information
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NPI Number | 1871040741
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Entity Type | Organization
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Legal Business Name | BROWARD OPHTHALMOLOGY GROUP
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 7401 N UNIVERSITY DR SUITE 201
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City | TAMARAC
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State | FL
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Zip | 33321-2979
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Country | US
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Telephone | 954-724-5100
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Fax | 954-724-5101
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Provider Business Mailing Address
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Address Line | 7401 N UNIVERSITY DR SUITE 201
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City | TAMARAC
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State | FL
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Zip | 33321-2979
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Country | US
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Telephone | 954-724-5100
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Fax | 954-724-5101
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Authorized Official
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Title or Position | DOO
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Name | CHERYL PAYNE
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Credential |
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Telephone | 19543187388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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