MEDICARE: ASSOCIATESMD BILLING & MANAGEMENT, 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	207Q00000X	Family Medicine Physician		FL

General Provider Information

NPI Number	:	1649752296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATESMD BILLING & MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	4780 SW 64TH AVE STE 103
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-4400
Country	:	US
Telephone Number	:	954-434-1705
Fax Number	:	855-289-2645

Provider Business Practice Location Address
First Line	:	600 S PINE ISLAND RD STE 104
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3178
Country	:	US
Telephone Number	:	954-474-4401
Fax Number	:	954-474-9883

Authorized Official
Title or Position	:	MGR
Name	:	RUNDEEP SINGH GADH
Credential	:
Telephone Number	:	954-474-4401

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	08/30/2018

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