Provider Demographics
NPI:1275867392
Name:SOUTH FLORIDA OCCUPATIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:SOUTH FLORIDA OCCUPATIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOUKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-242-2479
Mailing Address - Street 1:14201 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7224
Mailing Address - Country:US
Mailing Address - Phone:786-242-2479
Mailing Address - Fax:786-242-3982
Practice Address - Street 1:14201 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7224
Practice Address - Country:US
Practice Address - Phone:786-242-2479
Practice Address - Fax:786-242-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81042261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine