Provider Demographics
NPI:1861843823
Name:HOLLYWOOD HORMONE THERAPY
Entity Type:Organization
Organization Name:HOLLYWOOD HORMONE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-400-4575
Mailing Address - Street 1:5400 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5312
Mailing Address - Country:US
Mailing Address - Phone:305-842-0247
Mailing Address - Fax:954-399-6828
Practice Address - Street 1:5400 S UNIVERSITY DR
Practice Address - Street 2:SUITE 207
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5312
Practice Address - Country:US
Practice Address - Phone:305-842-0247
Practice Address - Fax:954-399-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111650207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty