Provider Demographics
NPI:1407208705
Name:DR. JEFFREY BISHOP & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DR. JEFFREY BISHOP & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MNGR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:754-234-0155
Mailing Address - Street 1:300 W SUNRISE BLVD
Mailing Address - Street 2:#3
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-6263
Mailing Address - Country:US
Mailing Address - Phone:754-234-0155
Mailing Address - Fax:
Practice Address - Street 1:300 W SUNRISE BLVD
Practice Address - Street 2:#3
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-6263
Practice Address - Country:US
Practice Address - Phone:754-234-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service