| Memorial Medical Group Of South Florida, Llc | |
|
4000 Hollywood Blvd Ste 555s Hollywood FL 33021-6853 | |
| (754) 273-0885 | |
| (754) 240-7841 |
| Full Name | Memorial Medical Group Of South Florida, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4000 Hollywood Blvd Ste 555s, Hollywood, Florida |
| Authorized Official Name and Position | Lisa B Marshall (OWNER) |
| Authorized Official Contact | 7542730885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Medical Group Of South Florida, Llc 16000 Pines Boulevard #822503 Pembroke Pines FL 33082-2503 Ph: (754) 273-0885 | Memorial Medical Group Of South Florida, Llc 4000 Hollywood Blvd Ste 555s Hollywood FL 33021-6853 Ph: (754) 273-0885 |
| NPI Number | 1841801297 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 06/18/2021 |
| Certification Date | 06/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841801297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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