Provider Demographics
NPI:1780406926
Name:MEDISUN MEDICAL CENTER 2 INC
Entity type:Organization
Organization Name:MEDISUN MEDICAL CENTER 2 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLOETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-281-0130
Mailing Address - Street 1:3521 W BROWARD BLVD STE 107-108
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1048
Mailing Address - Country:US
Mailing Address - Phone:954-281-0130
Mailing Address - Fax:954-281-0129
Practice Address - Street 1:3521 W BROWARD BLVD STE 107-108
Practice Address - Street 2:
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1048
Practice Address - Country:US
Practice Address - Phone:954-281-0130
Practice Address - Fax:954-281-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center