| Internal Medicine & Geriatric Health | |
|
2006 Ne 49th St Ft Lauderdale FL 33308-4524 | |
| (954) 938-8998 | |
| (954) 938-8984 |
| Full Name | Internal Medicine & Geriatric Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 2006 Ne 49th St, Ft Lauderdale, Florida |
| Authorized Official Name and Position | Theresa Fortaleza-dawson (OWNER) |
| Authorized Official Contact | 9549388998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine & Geriatric Health 6278 N Federal Hwy Suite 183 Ft Lauderdale FL 33308-1916 Ph: (954) 938-8998 | Internal Medicine & Geriatric Health 2006 Ne 49th St Ft Lauderdale FL 33308-4524 Ph: (954) 938-8998 |
| NPI Number | 1144426040 |
|---|---|
| Provider Enumeration Date | 06/26/2007 |
| Last Update Date | 01/24/2013 |
| Medicare PECOS PAC ID | 5698663391 |
|---|---|
| Medicare Enrollment ID | O20040305000102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144426040 | NPI | - | NPPES |
| 50293 | Other | FL | NEIGHBORHOOD HEALTH |
| 268019000 | Medicaid | FL | |
| 280599 | Other | FL | AVMED |
| 03018 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | ME81298 (Florida) | Primary |
| Provider Name | Theresa R Fortaleza Dawson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871507780 PECOS PAC ID: 5395633093 Enrollment ID: I20040308000045 |
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