| Broward Family Medical Group Llc | |
|
2701 Ne 14th Street Cswy Suite 5 Pompano Beach FL 33062-3535 | |
| (954) 545-1560 | |
| (954) 545-1560 |
| Full Name | Broward Family Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2701 Ne 14th Street Cswy, Pompano Beach, Florida |
| Authorized Official Name and Position | Glen A Waskin (OWNER) |
| Authorized Official Contact | 9545451560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broward Family Medical Group Llc 2701 Ne 14th Street Cswy Suite 5 Pompano Beach FL 33062-3535 Ph: (954) 545-1560 | Broward Family Medical Group Llc 2701 Ne 14th Street Cswy Suite 5 Pompano Beach FL 33062-3535 Ph: (954) 545-1560 |
| NPI Number | 1992984652 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 03/05/2008 |
| Medicare PECOS PAC ID | 2466536917 |
|---|---|
| Medicare Enrollment ID | O20080222000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992984652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Glen Andrew Waskin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427167204 PECOS PAC ID: 9335043397 Enrollment ID: I20040325000311 |
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