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General NPI Number Information
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NPI Number | 1972849784
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Entity Type | Organization
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Legal Business Name | AUDAX HEALTHCARE MANAGEMENT
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Dates
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Enumeration Date | 12/26/2012
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 6495 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-4110
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Country | US
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Telephone | 786-488-3410
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Fax | 866-592-1144
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Provider Business Mailing Address
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Address Line | 6495 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-4110
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Country | US
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Telephone | 786-488-3410
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Fax | 866-592-1144
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Authorized Official
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Title or Position | MGRM
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Name | FELIX DANIEL ALICEA
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Credential |
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Telephone | 786-488-3410
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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 | ME81676
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License Number State | FL
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