Provider Demographics
NPI:1740377357
Name:ADULT&GERIACTRIC INSTITUTE
Entity type:Organization
Organization Name:ADULT&GERIACTRIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:MENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-489-1345
Mailing Address - Street 1:4010 N OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6420
Mailing Address - Country:US
Mailing Address - Phone:954-566-5700
Mailing Address - Fax:954-566-5799
Practice Address - Street 1:4010 N OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-6420
Practice Address - Country:US
Practice Address - Phone:954-566-5700
Practice Address - Fax:954-566-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty