| Em9699 Llc | |
|
10480 Nw 11th Ct Plantation FL 33322-6585 | |
| (954) 868-2452 | |
| Not Available |
| Full Name | Em9699 Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 10480 Nw 11th Ct, Plantation, Florida |
| Authorized Official Name and Position | Linda Dolin (OWNER) |
| Authorized Official Contact | 9548682452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Em9699 Llc 10480 Nw 11th Ct Plantation FL 33322-6585 Ph: (954) 868-2452 | Em9699 Llc 10480 Nw 11th Ct Plantation FL 33322-6585 Ph: (954) 868-2452 |
| NPI Number | 1871959882 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 01/06/2016 |
| Medicare PECOS PAC ID | 7113217928 |
|---|---|
| Medicare Enrollment ID | O20160607002355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871959882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Linda Dolin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033107115 PECOS PAC ID: 2769381599 Enrollment ID: I20031231000287 |
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