HEALTHY SENIOR MEDICAL GROUP LLC NPI 1194327379

NPI Information

NPI: 1194327379
Provider Name: HEALTHY SENIOR MEDICAL GROUP LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
515 E LAS OLAS BLVD STE 120
FORT LAUDERDALE, FL
ZIP 33301
Phone: (954) 787-8874
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HEALTHY SENIOR MEDICAL GROUP LLC is a general practice in Fort Lauderdale, FL. HEALTHY SENIOR MEDICAL GROUP LLC NPI is 1194327379. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

515 E LAS OLAS BLVD STE 120
FORT LAUDERDALE, FL
ZIP 33301-261
Phone: (954) 787-8874
Fax: (954) 787-8875

The provider's authorized official is Christopher J Pettas .
The authorized official title is Ceo and has the following contact phone number (561) 702-1299.

The enumeration date for this NPI number is 11/12/2020 and was last updated on 11/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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