Provider Demographics
NPI:1639415482
Name:FLORIDA MEDICAL LINK
Entity Type:Organization
Organization Name:FLORIDA MEDICAL LINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-893-5675
Mailing Address - Street 1:3600 S STATE ROAD 7
Mailing Address - Street 2:SUITE 353
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5200
Mailing Address - Country:US
Mailing Address - Phone:954-893-5675
Mailing Address - Fax:954-981-7816
Practice Address - Street 1:3600 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5200
Practice Address - Country:US
Practice Address - Phone:954-893-5675
Practice Address - Fax:954-981-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211562251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care