Provider Demographics
NPI:1972930980
Name:BROWARD INTENSIVIST GROUP LLC
Entity Type:Organization
Organization Name:BROWARD INTENSIVIST GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLICKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-835-0005
Mailing Address - Street 1:9633 W BROWARD BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2332
Mailing Address - Country:US
Mailing Address - Phone:954-835-0005
Mailing Address - Fax:954-472-8271
Practice Address - Street 1:9633 W BROWARD BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2332
Practice Address - Country:US
Practice Address - Phone:954-835-0005
Practice Address - Fax:954-472-8271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5264207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty