Provider Demographics
NPI:1750378949
Name:FLORIDA INSTITUTE OF HEALTH LTD LLLP
Entity type:Organization
Organization Name:FLORIDA INSTITUTE OF HEALTH LTD LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRADOR
Authorized Official - Prefix:
Authorized Official - First Name:AVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-484-7030
Mailing Address - Street 1:4850 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7260
Mailing Address - Country:US
Mailing Address - Phone:954-484-7030
Mailing Address - Fax:954-484-1280
Practice Address - Street 1:7301 N UNIVERSITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2919
Practice Address - Country:US
Practice Address - Phone:954-726-2116
Practice Address - Fax:954-726-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041465207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
39523CMedicare ID - Type UnspecifiedFIH GROUP
94287YMedicare ID - Type Unspecified
D63188Medicare UPIN