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General NPI Number Information
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NPI Number | 1962995845
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE SPECIALIST OF SOUTH FLORIDA PA
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 4850 W OAKLAND PARK BLVD STE 143
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33313-7277
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Country | US
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Telephone | 786-275-3725
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Fax |
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Provider Business Mailing Address
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Address Line | 20200 W DIXIE HIGH WAY 1105A
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City | MIAMI
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State | FL
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Zip | 33301
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Country | US
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Telephone | 786-275-3727
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Fax | 305-599-4119
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Authorized Official
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Title or Position | OWNER
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Name | JARYNET BELTRAN
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Credential | ARNP
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Telephone | 954-937-4828
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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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