Provider Demographics
NPI:1205208139
Name:INNOVATIVE MEDICAL RESEARCH OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:INNOVATIVE MEDICAL RESEARCH OF SOUTH FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-759-1881
Mailing Address - Street 1:20880 WEST DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1115
Mailing Address - Country:US
Mailing Address - Phone:305-757-2226
Mailing Address - Fax:305-405-0535
Practice Address - Street 1:20880 WEST DIXIE HIGHWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1115
Practice Address - Country:US
Practice Address - Phone:305-757-2226
Practice Address - Fax:305-405-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME209541744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty