Provider Demographics
NPI:1548534878
Name:DEERFIELD MEDICAL CENTER,INC
Entity type:Organization
Organization Name:DEERFIELD MEDICAL CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:BOTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-242-1985
Mailing Address - Street 1:7522 WILES RD
Mailing Address - Street 2:SUITE B-213
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2062
Mailing Address - Country:US
Mailing Address - Phone:954-345-5556
Mailing Address - Fax:954-338-5371
Practice Address - Street 1:7522 WILES RD
Practice Address - Street 2:SUITE B-213
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2062
Practice Address - Country:US
Practice Address - Phone:954-345-5556
Practice Address - Fax:954-338-5371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center