Provider Demographics
NPI:1023361565
Name:INFUSION CENTER OF SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:INFUSION CENTER OF SOUTH FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:GLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-384-4155
Mailing Address - Street 1:4000 HOLLYWOOD BLVD
Mailing Address - Street 2:555-S
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6751
Mailing Address - Country:US
Mailing Address - Phone:303-384-4051
Mailing Address - Fax:720-497-9751
Practice Address - Street 1:1626 COLE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3306
Practice Address - Country:US
Practice Address - Phone:303-384-4051
Practice Address - Fax:720-497-9751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RV INFUSION PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty