Provider Demographics
NPI:1407841091
Name:BROWARD QUALITY LLC
Entity Type:Organization
Organization Name:BROWARD QUALITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-961-8394
Mailing Address - Street 1:6301 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2217
Mailing Address - Country:US
Mailing Address - Phone:954-961-8394
Mailing Address - Fax:954-241-0445
Practice Address - Street 1:6301 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-2217
Practice Address - Country:US
Practice Address - Phone:954-961-8394
Practice Address - Fax:954-241-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114506OtherHUMANA