Provider Demographics
NPI:1508075813
Name:SOUTH FLORIDA MEDICAL CENTERS, INC
Entity Type:Organization
Organization Name:SOUTH FLORIDA MEDICAL CENTERS, INC
Other - Org Name:SFMC GROUP OF POMPANO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADETULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-472-2999
Mailing Address - Street 1:33 S POMPANO PKWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3001
Mailing Address - Country:US
Mailing Address - Phone:954-974-8901
Mailing Address - Fax:
Practice Address - Street 1:33 S POMPANO PKWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3001
Practice Address - Country:US
Practice Address - Phone:954-974-8901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1476Medicare ID - Type UnspecifiedMEDICARE GROUP