| Intracoastal Primary Health | |
|
935 Intracoastal Dr Fort Lauderdale FL 33304-3623 | |
| (954) 530-7515 | |
| Not Available |
| Full Name | Intracoastal Primary Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 935 Intracoastal Dr, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Vijay Kumar Chowdhary (OWNER) |
| Authorized Official Contact | 9545307515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intracoastal Primary Health 935 Intracoastal Dr Fort Lauderdale FL 33304-3623 Ph: (954) 530-7515 | Intracoastal Primary Health 935 Intracoastal Dr Fort Lauderdale FL 33304-3623 Ph: (954) 530-7515 |
| NPI Number | 1922342229 |
|---|---|
| Provider Enumeration Date | 11/27/2012 |
| Last Update Date | 11/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922342229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME59508 (Florida) | Secondary |
| 207R00000X | Internal Medicine | ME59508 (Florida) | Primary |
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