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General NPI Number Information
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NPI Number | 1962886648
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Entity Type | Organization
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Legal Business Name | REAL MEDICAL INC
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 10078 NW 1ST CT
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City | PLANTATION
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State | FL
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Zip | 33324-7035
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Country | US
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Telephone | 895-447-2797
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Fax | 954-472-7941
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Provider Business Mailing Address
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Address Line | 10078 NW 1ST CT
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City | PLANTATION
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State | FL
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Zip | 33324-7035
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Country | US
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Telephone | 895-447-2797
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Fax | 954-472-7941
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Authorized Official
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Title or Position | OWNER
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Name | ERIC MARKSON
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Credential |
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Telephone | 954-472-7975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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