Provider Demographics
NPI:1407834138
Name:EMERGENCY MEDICINE SPECIALISTS OF SOUTH FLORIDA
Entity Type:Organization
Organization Name:EMERGENCY MEDICINE SPECIALISTS OF SOUTH FLORIDA
Other - Org Name:EMS OF SOUTH FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:877-751-1157
Mailing Address - Street 1:2030 NE 197TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 NW 95TH ST
Practice Address - Street 2:EMERGENCY MEDICINE SPECIALISTS OF SOUTH FLORIDA
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2038
Practice Address - Country:US
Practice Address - Phone:305-835-6191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7598207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274877100Medicaid
FL274877100Medicaid