Organization Name: | AMICUS MEDICAL CENTER LLC |
NPI Number: | 1033488382 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID R RODRIGUEZ (MGR) |
Mailing Address: | 12177 Pembroke Rd Pembroke Pines |
State: | FL US |
Postal Code: | 330251727 |
Phone Number: | 9544360555 |
Fax Number: | 9544360108 |
NPI Enumeration Date: | 12/15/2011 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME20616 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |