Provider Demographics
NPI:1881118669
Name:PHYSICIANS PARTNERS GROUP OF FLORIDA, LLC
Entity type:Organization
Organization Name:PHYSICIANS PARTNERS GROUP OF FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARLOW
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-538-6868
Mailing Address - Street 1:680 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6738
Mailing Address - Country:US
Mailing Address - Phone:954-538-6868
Mailing Address - Fax:
Practice Address - Street 1:5801 NW 151ST ST STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2437
Practice Address - Country:US
Practice Address - Phone:786-332-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service