| |
1010 Hollywood Blvd Hollywood FL 33019-1608 | |
(954) 483-3381 | |
(954) 516-0720 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1010 Hollywood Blvd, Hollywood, Florida |
Authorized Official Name and Position | Khaled Deeb (OWNER, AUTHORIZED OFFICIAL) |
Authorized Official Contact | 9544833811 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6813 Finamore Cir Lake Worth FL 33467-8727 Ph: (954) 483-3381 | 1010 Hollywood Blvd Hollywood FL 33019-1608 Ph: (954) 483-3381 |
NPI Number | 1962090993 |
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Provider Enumeration Date | 01/05/2021 |
Last Update Date | 04/02/2023 |
Medicare PECOS PAC ID | 9537577309 |
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Medicare Enrollment ID | O20210415000473 |
Identifier | Type | State | Issuer |
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1962090993 | NPI | - | NPPES |
Provider Name | Khaled Deeb |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1073044186 PECOS PAC ID: 0446668214 Enrollment ID: I20210419000401 |
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