| Practitioner Medical Services Inc | |
|
3075 Nw 35th Ave Lauderdale Lakes FL 33311-1107 | |
| (561) 843-2325 | |
| (561) 483-6266 |
| Full Name | Practitioner Medical Services Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3075 Nw 35th Ave, Lauderdale Lakes, Florida |
| Authorized Official Name and Position | Marie Michelle Carner (PRESIDENT) |
| Authorized Official Contact | 5618432325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Practitioner Medical Services Inc 22274 Sw 61st Ave Boca Raton FL 33428-4410 Ph: (561) 843-2325 | Practitioner Medical Services Inc 3075 Nw 35th Ave Lauderdale Lakes FL 33311-1107 Ph: (561) 843-2325 |
| NPI Number | 1548545601 |
|---|---|
| Provider Enumeration Date | 10/19/2011 |
| Last Update Date | 09/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548545601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | P11000009589 (Florida) | Primary |
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