MEDICARE: FLORIDA INSTITUTE OF HEALTH LTD LLLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician

General Provider Information

NPI Number	:	1053416339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA INSTITUTE OF HEALTH LTD LLLP

Provider Business Mailing Address
First Line	:	4850 W OAKLAND PARK BLVD
Second Line	:	SUITE 205
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-7260
Country	:	US
Telephone Number	:	954-484-7030
Fax Number	:	954-484-1280

Provider Business Practice Location Address
First Line	:	7351 W OAKLAND PARK BLVD
Second Line	:	SUITE 104
City	:	TAMARAC
State	:	FL
Zip	:	33319-7107
Country	:	US
Telephone Number	:	954-741-5800
Fax Number	:	954-741-7828

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. AVA ZAKEN
Credential	:
Telephone Number	:	954-484-7030

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	10/24/2007

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