MEDICARE: ADULT&GERIACTRIC INSTITUTE

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	174400000X	Specialist

General Provider Information

NPI Number	:	1740377357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULT&GERIACTRIC INSTITUTE

Provider Business Mailing Address
First Line	:	4010 N OCEAN BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6420
Country	:	US
Telephone Number	:	954-566-5700
Fax Number	:	954-566-5799

Provider Business Practice Location Address
First Line	:	4010 N OCEAN BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6420
Country	:	US
Telephone Number	:	954-566-5700
Fax Number	:	954-566-5799

Authorized Official
Title or Position	:	MD
Name	:	ANDRES MENCIA
Credential	:
Telephone Number	:	954-489-1345

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/22/2020

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Directions to “ADULT&GERIACTRIC INSTITUTE ” Practice Location

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