MEDICARE: PRINCE OF PEACE MEDICAL CENTER, 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1598535973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCE OF PEACE MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	2964 N STATE ROAD 7 STE 310
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5715
Country	:	US
Telephone Number	:	954-606-6993
Fax Number	:

Provider Business Practice Location Address
First Line	:	2964 N STATE ROAD 7 STE 310
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5715
Country	:	US
Telephone Number	:	954-278-2646
Fax Number	:	954-278-2646

Authorized Official
Title or Position	:	MD
Name	:	SLABINE ANTOINE MENELAS
Credential	:
Telephone Number	:	954-606-6993

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	02/04/2026

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