Provider Demographics
NPI:1659933182
Name:SOUTH FLORIDA HEALTHCARE PRACTITIONERS
Entity Type:Organization
Organization Name:SOUTH FLORIDA HEALTHCARE PRACTITIONERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAN JUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-732-0457
Mailing Address - Street 1:8553 SHERATON DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8553 SHERATON DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-2826
Practice Address - Country:US
Practice Address - Phone:954-732-0457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-04
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty