Provider Demographics
NPI:1649589037
Name:FORZA MEDICIAL GROUP
Entity Type:Organization
Organization Name:FORZA MEDICIAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FORZAANO
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:954-755-9079
Mailing Address - Street 1:8433 FOREST HILLS DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5481
Mailing Address - Country:US
Mailing Address - Phone:954-755-9079
Mailing Address - Fax:
Practice Address - Street 1:8433 FOREST HILLS DR
Practice Address - Street 2:SUITE 301
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5481
Practice Address - Country:US
Practice Address - Phone:954-755-9079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2889261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care