| Family Medical Center Of Hollywood Pa | |
|
4050 Sheridan St Suite C Hollywood FL 33021-3561 | |
| (954) 889-0211 | |
| (954) 889-0213 |
| Full Name | Family Medical Center Of Hollywood Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4050 Sheridan St, Hollywood, Florida |
| Authorized Official Name and Position | Michael Joachim Mckenzie (PRESIDENT) |
| Authorized Official Contact | 9548890211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center Of Hollywood Pa 4050 Sheridan St Suite C Hollywood FL 33021-3561 Ph: (954) 889-0211 | Family Medical Center Of Hollywood Pa 4050 Sheridan St Suite C Hollywood FL 33021-3561 Ph: (954) 889-0211 |
| NPI Number | 1790940864 |
|---|---|
| Provider Enumeration Date | 07/28/2008 |
| Last Update Date | 09/16/2009 |
| Medicare PECOS PAC ID | 6507901881 |
|---|---|
| Medicare Enrollment ID | O20100311000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790940864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME87219 (Florida) | Primary |
| Provider Name | Michael H Mckenzie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538146725 PECOS PAC ID: 1355248378 Enrollment ID: I20031217000932 |
| Provider Name | Liliana M Awan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376657122 PECOS PAC ID: 4385640275 Enrollment ID: I20080126000062 |
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