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General NPI Number Information
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NPI Number | 1891257986
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Entity Type | Organization
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Legal Business Name | ER & DC MCPHERSON HOLDINGS LLC
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Dates
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Enumeration Date | 04/05/2019
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 6957 W BROWARD BLVD
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City | PLANTATION
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State | FL
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Zip | 33317-2917
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Country | US
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Telephone | 954-261-3280
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Fax | 305-203-0546
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Provider Business Mailing Address
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Address Line | 6957 W BROWARD BLVD
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City | PLANTATION
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State | FL
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Zip | 33317-2917
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Country | US
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Telephone | 954-261-3280
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Fax | 305-203-0546
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MS. DONNA LEA FONDA
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Credential |
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Telephone | 305-517-1219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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