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NPI Code Detail

MEDICARE: PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL

MEDICARE: PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL
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 Physician

General Provider Information

NPI Number : 1962992651
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL
Provider Business Mailing Address
First Line : 1400 SE 2ND CT
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-3934
Country : US
Telephone Number : 305-343-0604
Fax Number :
Provider Business Practice Location Address
First Line : 7050 TAFT ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33024-3804
Country : US
Telephone Number : 954-399-9014
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MOISES A ISSA
Credential : MD
Telephone Number : 305-343-0604
Provider Enumeration Date : 05/17/2018
Last Update Date : 01/07/2023

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Directions to “PRIMARY CARE PHYSICIANS OF HOLLYWOOD, PL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.