| |
3400 Nw 9th Ave Ste A Oakland Park FL 33309-5948 | |
(954) 462-4599 | |
(888) 964-6060 |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 3400 Nw 9th Ave Ste A, Oakland Park, Florida |
Authorized Official Name and Position | Maria Freeman (PRESIDENT) |
Authorized Official Contact | 9545342220 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 14303 Fort Lauderdale FL 33302-4303 Ph: (954) 462-4599 | 3400 Nw 9th Ave Ste A Oakland Park FL 33309-5948 Ph: (954) 462-4599 |
NPI Number | 1104156249 |
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Provider Enumeration Date | 01/13/2010 |
Last Update Date | 01/14/2022 |
Medicare PECOS PAC ID | 4284760760 |
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Medicare Enrollment ID | O20100414000250 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104156249 | NPI | - | NPPES |
001754300 | Medicaid | FL | |
CX83A | Other | FL | MEDICARE |
Provider Name | Michael Pierce |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1205859188 PECOS PAC ID: 8426150830 Enrollment ID: I20140929001086 |
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