| Las Olas Medical Group & Spa | |
|
2607 Ne 10th Ave Wilton Manors FL 33334-3707 | |
| (954) 763-1230 | |
| (954) 763-1238 |
| Full Name | Las Olas Medical Group & Spa |
|---|---|
| Speciality | Family Medicine |
| Location | 2607 Ne 10th Ave, Wilton Manors, Florida |
| Authorized Official Name and Position | Jeffrey S Caron (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9547631230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Las Olas Medical Group & Spa 2607 Ne 10th Ave Wilton Manors FL 33334-3707 Ph: (954) 763-1230 | Las Olas Medical Group & Spa 2607 Ne 10th Ave Wilton Manors FL 33334-3707 Ph: (954) 763-1230 |
| NPI Number | 1467472068 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 08/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467472068 | NPI | - | NPPES |
| 066841900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME82806 (Florida) | Primary |
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