Provider Demographics
NPI:1326701004
Name:EMC SERVICES OF FLORIDA LLC
Entity Type:Organization
Organization Name:EMC SERVICES OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GRNJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-612-7502
Mailing Address - Street 1:210 SOUTH FEDERAL HIGHWAY
Mailing Address - Street 2:SUITE #402
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6811
Mailing Address - Country:US
Mailing Address - Phone:954-649-4275
Mailing Address - Fax:
Practice Address - Street 1:210 SOUTH FEDERAL HIGHWAY
Practice Address - Street 2:SUITE #402
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6811
Practice Address - Country:US
Practice Address - Phone:954-649-4275
Practice Address - Fax:954-399-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty