Organization Name: | MERIDIAN MEDICAL CENTER INC |
NPI Number: | 1265870752 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ADEILSON JORGE (PRESIDENT) |
Mailing Address: | 5975 W Sunrise Blvd Suite 106 Plantation |
State: | FL US |
Postal Code: | 333136801 |
Phone Number: | 9542008362 |
Fax Number: | 9542064458 |
NPI Enumeration Date: | 06/06/2013 |
NPI Last Update Date: | 06/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |