MEDICARE: DAVIE MEDI CENTER

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	174400000X	Specialist	ME75421	FL

General Provider Information

NPI Number	:	1528013976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVIE MEDI CENTER

Provider Business Mailing Address
First Line	:	3181 DAVIE BLVD
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33312-2728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3181 DAVIE BLVD
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33312-2728
Country	:	US
Telephone Number	:	954-321-5498
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GUZ MUNOZ
Credential	:
Telephone Number	:	954-321-5498

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/31/2007

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Directions to “DAVIE MEDI CENTER ” Practice Location

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