Provider Demographics
NPI:1821471947
Name:DEERFIELD HEALTH CLINIC, LLC
Entity Type:Organization
Organization Name:DEERFIELD HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HIRSHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:813-455-1557
Mailing Address - Street 1:505 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4109
Mailing Address - Country:US
Mailing Address - Phone:954-880-2595
Mailing Address - Fax:888-794-7864
Practice Address - Street 1:525 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4153
Practice Address - Country:US
Practice Address - Phone:954-880-2595
Practice Address - Fax:888-794-7864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Multi-Specialty