Provider Demographics
NPI:1568619880
Name:BROWARD MEDICAL ASSOCIATES OF SOUTH FLORIDA,INC
Entity Type:Organization
Organization Name:BROWARD MEDICAL ASSOCIATES OF SOUTH FLORIDA,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RUDOLF
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-424-9300
Mailing Address - Street 1:7390 NW 5TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1610
Mailing Address - Country:US
Mailing Address - Phone:954-424-9300
Mailing Address - Fax:954-424-3315
Practice Address - Street 1:7390 NW 5TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1610
Practice Address - Country:US
Practice Address - Phone:954-424-9300
Practice Address - Fax:954-424-3315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40710208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty