Provider Demographics
NPI:1093084014
Name:PREVENTIVE MEDICINE ASSOCIATES LLC
Entity Type:Organization
Organization Name:PREVENTIVE MEDICINE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:ERWIN
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-600-9047
Mailing Address - Street 1:4800 SW 198TH TER
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1135
Mailing Address - Country:US
Mailing Address - Phone:954-600-9047
Mailing Address - Fax:
Practice Address - Street 1:4800 SW 198TH TER
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33332-1135
Practice Address - Country:US
Practice Address - Phone:954-600-9047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty