Revelation Family Medicine Office, Llc. | |
3939 Hollywood Blvd Ste 300b Hollywood FL 33021-6749 | |
(786) 863-8633 | |
Not Available |
Full Name | Revelation Family Medicine Office, Llc. |
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Speciality | Family Medicine - Adult Medicine |
Location | 3939 Hollywood Blvd Ste 300b, Hollywood, Florida |
Authorized Official Name and Position | Jean-marcel Forte (CERTIFIED PHYSICIAN ASSISTANT) |
Authorized Official Contact | 3058074283 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Revelation Family Medicine Office, Llc. 3939 Hollywood Blvd Ste 300b Hollywood FL 33021-6749 Ph: (786) 863-8633 | Revelation Family Medicine Office, Llc. 3939 Hollywood Blvd Ste 300b Hollywood FL 33021-6749 Ph: (786) 863-8633 |
NPI Number | 1912472200 |
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Provider Enumeration Date | 10/12/2018 |
Last Update Date | 10/12/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912472200 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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