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NPI Code Detail

MEDICARE: PHOENIX EMERGENCY MEDICINE OF BROWARD LLC

MEDICARE: PHOENIX EMERGENCY MEDICINE OF BROWARD LLC
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 Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407805591
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHOENIX EMERGENCY MEDICINE OF BROWARD LLC
Provider Business Mailing Address
First Line : PO BOX 781184
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-1184
Country : US
Telephone Number : 954-939-5000
Fax Number : 877-250-6889
Provider Business Practice Location Address
First Line : 201 E SAMPLE RD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33064-3502
Country : US
Telephone Number : 954-939-5000
Fax Number : 877-250-6889
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : CHRISTOPHER KENNEDY
Credential :
Telephone Number : 207-807-9009
Provider Enumeration Date : 05/08/2006
Last Update Date : 06/01/2026

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Directions to “PHOENIX EMERGENCY MEDICINE OF BROWARD LLC ” Practice Location

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