Provider Demographics
NPI:1821124538
Name:THE MEDITREND GROUP, INC.
Entity Type:Organization
Organization Name:THE MEDITREND GROUP, INC.
Other - Org Name:THE MEDITREND GROUP, INC. - OUTPATIENT SURGICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-633-1008
Mailing Address - Street 1:2030 W MCNAB RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1002
Mailing Address - Country:US
Mailing Address - Phone:954-633-1000
Mailing Address - Fax:954-633-1024
Practice Address - Street 1:301 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1811
Practice Address - Country:US
Practice Address - Phone:954-633-1008
Practice Address - Fax:954-633-1024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MEDITREND GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-26
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory