1992969828 NPI number — HOSPITALIST M D ASSOCIATES LLC

Table of content: (NPI 1992969828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992969828 NPI number — HOSPITALIST M D ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITALIST M D ASSOCIATES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992969828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 279425
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33027-9425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-885-4299
Provider Business Mailing Address Fax Number:
954-885-4298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10021 PINES BLVD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
PEMBROKE PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33024-6191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-885-4299
Provider Business Practice Location Address Fax Number:
954-885-4298
Provider Enumeration Date:
07/10/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PINA
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
954-885-4299

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)