Provider Demographics
NPI:1043221146
Name:CLINICAL PARTNERS INC
Entity Type:Organization
Organization Name:CLINICAL PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GERDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-545-0337
Mailing Address - Street 1:92 E MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-9238
Mailing Address - Country:US
Mailing Address - Phone:954-545-0337
Mailing Address - Fax:954-545-3497
Practice Address - Street 1:350 CROSSGATES BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2601
Practice Address - Country:US
Practice Address - Phone:954-545-0337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09015727Medicaid
MSCH9611OtherRAIL ROAD MEDICARE
MSCH9611OtherRAIL ROAD MEDICARE