Provider Demographics
NPI:1124371281
Name:SOUTH FLORIDA PRIMARY CARE L.L.C.
Entity Type:Organization
Organization Name:SOUTH FLORIDA PRIMARY CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:CANER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:754-222-8524
Mailing Address - Street 1:8333 W MCNAB RD STE 113
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-3203
Mailing Address - Country:US
Mailing Address - Phone:754-222-2852
Mailing Address - Fax:754-222-8596
Practice Address - Street 1:8333 W MCNAB RD STE 113
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-3203
Practice Address - Country:US
Practice Address - Phone:754-222-8524
Practice Address - Fax:754-222-8596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty