| Coral Ridge Outpatient Center | |
|
5301 N Dixie Hwy Suite 100 Oakland Park FL 33334-3403 | |
| (954) 832-3300 | |
| (954) 832-3301 |
| Full Name | Coral Ridge Outpatient Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 5301 N Dixie Hwy, Oakland Park, Florida |
| Authorized Official Name and Position | Collin Lemaistre (OFFICER / AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2142130732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coral Ridge Outpatient Center 5301 N Dixie Hwy Oakland Park FL 33334 Ph: (954) 832-3300 | Coral Ridge Outpatient Center 5301 N Dixie Hwy Suite 100 Oakland Park FL 33334-3403 Ph: (954) 832-3300 |
| NPI Number | 1114126596 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 09/06/2024 |
| Medicare PECOS PAC ID | 6901956952 |
|---|---|
| Medicare Enrollment ID | O20090612000060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114126596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | 1310 (Florida) | Primary |
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