Provider Demographics
NPI:1376877514
Name:TENET FLORIDA PHYSICIAN SERVICES, LLC
Entity Type:Organization
Organization Name:TENET FLORIDA PHYSICIAN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP, OPS FINANCE & PMI, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:J.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-6960
Mailing Address - Street 1:5810 CORAL RIDGE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3374
Mailing Address - Country:US
Mailing Address - Phone:954-509-3650
Mailing Address - Fax:954-796-7268
Practice Address - Street 1:6175 NW 153RD ST
Practice Address - Street 2:STE 225
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-2435
Practice Address - Country:US
Practice Address - Phone:305-698-6292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty