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NPI Code Detail

MEDICARE: SIGNATURE HEALTH SERVICES INC

MEDICARE: SIGNATURE HEALTH SERVICES INC
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
1207Q00000XFamily Medicine PhysicianHCC4684FL
2261QP2300XPrimary Care Clinic/CenterHCC4684FL

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 : 1619995578
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIGNATURE HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 1711 HAMMONDVILLE RD
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-1989
Country : US
Telephone Number : 954-972-6450
Fax Number : 954-972-7028
Provider Business Practice Location Address
First Line : 1711 HAMMONDVILLE RD
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-1989
Country : US
Telephone Number : 954-972-6450
Fax Number : 954-972-7028
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. DALE GIBSON
Credential :
Telephone Number : 954-972-6450
Provider Enumeration Date : 07/18/2006
Last Update Date : 12/16/2009

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Directions to “SIGNATURE HEALTH SERVICES INC ” Practice Location

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