Provider Demographics
NPI:1427591585
Name:MULTISPECIALTYHEALTHCARE LLC
Entity Type:Organization
Organization Name:MULTISPECIALTYHEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-609-7989
Mailing Address - Street 1:1480 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6040
Mailing Address - Country:US
Mailing Address - Phone:954-840-0530
Mailing Address - Fax:954-840-3570
Practice Address - Street 1:1480 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6040
Practice Address - Country:US
Practice Address - Phone:954-840-0530
Practice Address - Fax:954-840-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95185207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME95185OtherFLORIDA DOH