Provider Demographics
NPI:1609811298
Name:BROWARD PHYSICIAN CLINIC
Entity Type:Organization
Organization Name:BROWARD PHYSICIAN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-923-6070
Mailing Address - Street 1:732 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4314
Mailing Address - Country:US
Mailing Address - Phone:954-923-6070
Mailing Address - Fax:954-923-6747
Practice Address - Street 1:732 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-4314
Practice Address - Country:US
Practice Address - Phone:954-923-6070
Practice Address - Fax:954-923-6747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCCR2445174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty