MEDICARE: PATIENT FIRST MEDICAL CENTER, 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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1679712517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENT FIRST MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	1110 E HALLANDALE BEACH BLVD
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4432
Country	:	US
Telephone Number	:	954-862-8700
Fax Number	:	954-862-8707

Provider Business Practice Location Address
First Line	:	1110 E HALLANDALE BEACH BLVD
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-4432
Country	:	US
Telephone Number	:	954-862-8700
Fax Number	:	954-862-8707

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VLADIMIR REPNIN
Credential	:
Telephone Number	:	954-862-8700

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	04/04/2012

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