Provider Demographics
NPI:1437857323
Name:SOUTH FLORIDA ADDICTION MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA ADDICTION MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POSNER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:561-571-0922
Mailing Address - Street 1:1200 N FEDERAL HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-2813
Mailing Address - Country:US
Mailing Address - Phone:561-571-0922
Mailing Address - Fax:561-277-0846
Practice Address - Street 1:1200 N FEDERAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-2813
Practice Address - Country:US
Practice Address - Phone:561-571-0922
Practice Address - Fax:561-277-0846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty