| Multispecialtyhealthcare Llc | |
|
1480 N University Dr Coral Springs FL 33071-6040 | |
| (954) 840-0530 | |
| (954) 840-3570 |
| Full Name | Multispecialtyhealthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1480 N University Dr, Coral Springs, Florida |
| Authorized Official Name and Position | Michael Neal Funk (MD/SOLE OWNER) |
| Authorized Official Contact | 9546097989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Multispecialtyhealthcare Llc 1480 N University Dr Coral Springs FL 33071-6040 Ph: (954) 840-0530 | Multispecialtyhealthcare Llc 1480 N University Dr Coral Springs FL 33071-6040 Ph: (954) 840-0530 |
| NPI Number | 1427591585 |
|---|---|
| Provider Enumeration Date | 11/22/2016 |
| Last Update Date | 07/05/2021 |
| Medicare PECOS PAC ID | 7012347347 |
|---|---|
| Medicare Enrollment ID | O20200428001564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427591585 | NPI | - | NPPES |
| ME95185 | Other | FL | FLORIDA DOH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME95185 (Florida) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | ME95185 (Florida) | Primary |
| Provider Name | Michael N Funk |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891956975 PECOS PAC ID: 8921163304 Enrollment ID: I20090218000582 |
| Provider Name | Carmen Alitza Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770066672 PECOS PAC ID: 9032456272 Enrollment ID: I20190128000238 |
| Provider Name | Natasha Lee Tate- Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013493840 PECOS PAC ID: 0840538187 Enrollment ID: I20190213000290 |
| Provider Name | Samuel Fixler Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750813895 PECOS PAC ID: 1557648060 Enrollment ID: I20200611002518 |
| Provider Name | Vivian Aguiar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205283975 PECOS PAC ID: 8426341686 Enrollment ID: I20200721001225 |
| Provider Name | Jegan Gabbidon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932764685 PECOS PAC ID: 9133455272 Enrollment ID: I20220910000012 |
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