Provider Demographics
NPI:1790116408
Name:SOUTH FLORIDA HEALTHCARE LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNABE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-663-6562
Mailing Address - Street 1:11760 SW 40TH ST
Mailing Address - Street 2:SUITE 616
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3582
Mailing Address - Country:US
Mailing Address - Phone:954-663-6562
Mailing Address - Fax:
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 616
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:954-663-6562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102762207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty