Provider Demographics
NPI:1669095055
Name:SOUTH FLORIDA INJURY CENTERS, INC.
Entity type:Organization
Organization Name:SOUTH FLORIDA INJURY CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-606-6325
Mailing Address - Street 1:291 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1625
Mailing Address - Country:US
Mailing Address - Phone:954-606-6325
Mailing Address - Fax:
Practice Address - Street 1:5715 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4635
Practice Address - Country:US
Practice Address - Phone:954-606-6325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH FLORIDA INJURY CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-20
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty