Provider Demographics
NPI:1497230528
Name:DYNAMIC MEDICAL MANAGEMENT SOLUTIONS
Entity type:Organization
Organization Name:DYNAMIC MEDICAL MANAGEMENT SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATING EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:GEMINISA
Authorized Official - Middle Name:MELANIE
Authorized Official - Last Name:SOLORZANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-667-5465
Mailing Address - Street 1:801 SW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4237
Mailing Address - Country:US
Mailing Address - Phone:954-667-5465
Mailing Address - Fax:954-699-0790
Practice Address - Street 1:6100 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-6030
Practice Address - Country:US
Practice Address - Phone:954-404-7704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No305S00000XManaged Care OrganizationsPoint of Service
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherNON MEDICAL