Provider Demographics
NPI:1023896016
Name:PHYSICIANS PARTNERSHIP ALLIANCE, LLC
Entity type:Organization
Organization Name:PHYSICIANS PARTNERSHIP ALLIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-878-3072
Mailing Address - Street 1:10081 PINES BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6171
Mailing Address - Country:US
Mailing Address - Phone:954-251-1175
Mailing Address - Fax:786-732-0460
Practice Address - Street 1:10081 PINES BLVD STE B
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6171
Practice Address - Country:US
Practice Address - Phone:954-251-1175
Practice Address - Fax:786-732-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1134407307OtherALBERTO MANZOR