Provider Demographics
NPI:1497012819
Name:INVESCLINIC
Entity Type:Organization
Organization Name:INVESCLINIC
Other - Org Name:SOUTHEAST MEDICAL CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMBRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-684-3266
Mailing Address - Street 1:4401 N ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3917
Mailing Address - Country:US
Mailing Address - Phone:954-202-5137
Mailing Address - Fax:
Practice Address - Street 1:4401 N ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-3917
Practice Address - Country:US
Practice Address - Phone:954-202-5137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty