Organization Name: | ALLIANCE MEDICAL CARE GROUP LLC |
NPI Number: | 1700181021 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSE J CASTANEDA (PHYSICIAN ASSOCIATE / MANAGER) |
Mailing Address: | 9869 Pines Blvd Pembroke Pines |
State: | FL US |
Postal Code: | 330246100 |
Phone Number: | 9544507998 |
Fax Number: | 9544509991 |
NPI Enumeration Date: | 01/18/2011 |
NPI Last Update Date: | 09/05/2012 |
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: |