Provider Demographics
NPI:1548594484
Name:SOUTH FLORIDA REGIONAL HEALTHCARE PROVIDERS, LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA REGIONAL HEALTHCARE PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGAROLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-218-8340
Mailing Address - Street 1:351 NW 42ND AVE
Mailing Address - Street 2:308
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5683
Mailing Address - Country:US
Mailing Address - Phone:305-817-5402
Mailing Address - Fax:305-817-5408
Practice Address - Street 1:351 NW 42ND AVE
Practice Address - Street 2:308
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5683
Practice Address - Country:US
Practice Address - Phone:305-817-5402
Practice Address - Fax:305-817-5408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37215208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty