Organization Name: | SOUTH FLORIDA PHYSICIAN CARE NETWORK P.A. |
NPI Number: | 1205195534 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | OSWALDO S SANDOVAL (PRESIDENT) |
Mailing Address: | 4910 E 2nd Ave Hialeah |
State: | FL US |
Postal Code: | 330131410 |
Phone Number: | 3056316840 |
Fax Number: | 3056316894 |
NPI Enumeration Date: | 05/07/2012 |
NPI Last Update Date: | 05/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |