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NPI Code Detail

MEDICARE: BORIKEN FAMILY HEALTH AND WELLNESS CENTER PL

MEDICARE: BORIKEN FAMILY HEALTH AND WELLNESS CENTER PL
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
1207P00000XEmergency Medicine PhysicianME85860FL
2207Q00000XFamily Medicine PhysicianME86754FL

General Provider Information

NPI Number : 1265766224
Entity Type Code : Organization
Provider Name (Legal Business Name) : BORIKEN FAMILY HEALTH AND WELLNESS CENTER PL
Provider Business Mailing Address
First Line : 12600 PEMBROKE RD STE 208
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-2544
Country : US
Telephone Number : 954-620-0026
Fax Number : 954-620-0047
Provider Business Practice Location Address
First Line : 12600 PEMBROKE RD STE 208
Second Line :
City : MIRAMAR
State : FL
Zip : 33027-2544
Country : US
Telephone Number : 954-620-0026
Fax Number : 954-620-0047
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MANUEL FERNANDEZ
Credential : MD
Telephone Number : 305-331-1916
Provider Enumeration Date : 09/23/2009
Last Update Date : 06/26/2026

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Directions to “BORIKEN FAMILY HEALTH AND WELLNESS CENTER PL ” Practice Location

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