Provider Demographics
NPI: | 1003231788 |
---|---|
Name: | DOCTORS BILLING LLC |
Entity Type: | Organization |
Organization Name: | DOCTORS BILLING LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANDREY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROSSIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 786-942-0502 |
Mailing Address - Street 1: | 2310 SE 2ND ST |
Mailing Address - Street 2: | SUITE 7 |
Mailing Address - City: | BOYNTON BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33435-7280 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2310 SE 2ND ST |
Practice Address - Street 2: | SUITE 7 |
Practice Address - City: | BOYNTON BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33435-7280 |
Practice Address - Country: | US |
Practice Address - Phone: | 786-942-0502 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-03-04 |
Last Update Date: | 2014-03-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ME83014 | 2084P0802X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084P0802X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Psychiatry | Group - Single Specialty |