Provider Demographics
NPI:1629818851
Name:INJURY PHYSICIANS NETWORK LLC
Entity type:Organization
Organization Name:INJURY PHYSICIANS NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:305-587-5599
Mailing Address - Street 1:13911 SW 42ND ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6407
Mailing Address - Country:US
Mailing Address - Phone:305-587-5599
Mailing Address - Fax:305-851-0427
Practice Address - Street 1:7000 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1016
Practice Address - Country:US
Practice Address - Phone:305-587-5599
Practice Address - Fax:305-851-0427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty