Provider Demographics
NPI:1679744023
Name:AMERICAN HOSPITALIST COMPANY PL
Entity Type:Organization
Organization Name:AMERICAN HOSPITALIST COMPANY PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:H
Authorized Official - Last Name:BIVINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-607-9181
Mailing Address - Street 1:304 INDIAN TRCE
Mailing Address - Street 2:SUITE 167
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2996
Mailing Address - Country:US
Mailing Address - Phone:904-281-0944
Mailing Address - Fax:904-281-9806
Practice Address - Street 1:9711 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7013
Practice Address - Country:US
Practice Address - Phone:904-281-0944
Practice Address - Fax:904-281-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52294208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259948100Medicaid
FL259948100Medicaid