MEDICARE: APEX SOUTH FLORIDA 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
1	261QM2500X	Medical Specialty Clinic/Center	ME 55294	FL

General Provider Information

NPI Number	:	1548587447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX SOUTH FLORIDA LLC

Provider Business Mailing Address
First Line	:	2701 W OAKLAND PARK BLVD
Second Line	:	SUITE 315
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1388
Country	:	US
Telephone Number	:	954-484-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 W OAKLAND PARK BLVD
Second Line	:	SUITE 315
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1388
Country	:	US
Telephone Number	:	954-484-0300
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	WILLIAM STEVE HASTON
Credential	:	M.D.
Telephone Number	:	954-484-0300

Provider Enumeration Date	:	05/01/2010
Last Update Date	:	05/01/2010

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Directions to “APEX SOUTH FLORIDA LLC ” Practice Location

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