Provider Demographics
NPI:1578745139
Name:BROWARD FAMILY PHYSICIANS INC
Entity Type:Organization
Organization Name:BROWARD FAMILY PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-658-9687
Mailing Address - Street 1:121 S ORANGE AVE
Mailing Address - Street 2:SUITE 940
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3221
Mailing Address - Country:US
Mailing Address - Phone:407-658-9687
Mailing Address - Fax:407-658-9688
Practice Address - Street 1:2901 W. OAKLAND BLVD.
Practice Address - Street 2:SUITE A4
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-3400
Practice Address - Country:US
Practice Address - Phone:954-484-9590
Practice Address - Fax:954-486-5690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAK235Medicare PIN