Provider Demographics
NPI:1659757755
Name:SOUTH FLORIDA INTERNAL MEDICINE PLLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRAJ
Authorized Official - Middle Name:V
Authorized Official - Last Name:TIRMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:954-800-0931
Mailing Address - Street 1:P.O. BOX 24696
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33307
Mailing Address - Country:US
Mailing Address - Phone:954-800-0931
Mailing Address - Fax:954-800-0931
Practice Address - Street 1:911 E OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-2725
Practice Address - Country:US
Practice Address - Phone:954-800-0931
Practice Address - Fax:954-800-0931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102836207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty