Provider Demographics
NPI:1033475900
Name:SCIBERRAS INTERNAL MEDICINE INC
Entity Type:Organization
Organization Name:SCIBERRAS INTERNAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIBERRAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-399-9941
Mailing Address - Street 1:3801 S OCEAN DR
Mailing Address - Street 2:5F
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2925
Mailing Address - Country:US
Mailing Address - Phone:718-510-2561
Mailing Address - Fax:
Practice Address - Street 1:101 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-3622
Practice Address - Country:US
Practice Address - Phone:954-399-9941
Practice Address - Fax:954-399-9987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9687261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279454300Medicaid
FL279454300Medicaid