Provider Demographics
NPI:1053089953
Name:MD HEALTHCARE HILLSBORO
Entity Type:Organization
Organization Name:MD HEALTHCARE HILLSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESERBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-229-9733
Mailing Address - Street 1:304 INDIAN TRCE STE 636
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2996
Mailing Address - Country:US
Mailing Address - Phone:954-425-9154
Mailing Address - Fax:954-425-9162
Practice Address - Street 1:220 SW NATURA AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-3026
Practice Address - Country:US
Practice Address - Phone:954-425-9154
Practice Address - Fax:954-425-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care