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General NPI Number Information
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NPI Number | 1972930980
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Entity Type | Organization
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Legal Business Name | BROWARD INTENSIVIST GROUP LLC
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 9633 W BROWARD BLVD SUITE 6
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City | PLANTATION
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State | FL
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Zip | 33324-2332
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Country | US
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Telephone | 954-835-0005
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Fax | 954-472-8271
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Provider Business Mailing Address
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Address Line | 9633 W BROWARD BLVD SUITE 6
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City | PLANTATION
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State | FL
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Zip | 33324-2332
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Country | US
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Telephone | 954-835-0005
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Fax | 954-472-8271
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL A FLICKER
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Credential | DO
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Telephone | 954-835-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | OS5264
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License Number State | FL
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