Organization Name: | DUVAL EMERGENCY GROUP LLC |
NPI Number: | 1053645465 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISHA C FALK (VP OF CONTRACTING) |
Mailing Address: | 160 Nw 170th St North Miami Beach |
State: | FL US |
Postal Code: | 331695521 |
Phone Number: | 3056511100 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2009 |
NPI Last Update Date: | 01/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |