| Weston Medical Clinic Inc | |
|
17120 Royal Palm Blvd Suite 4 Weston FL 33326-2310 | |
| (954) 385-3711 | |
| (954) 385-9366 |
| Full Name | Weston Medical Clinic Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17120 Royal Palm Blvd, Weston, Florida |
| Authorized Official Name and Position | Phanor Calle (PRESIDENT) |
| Authorized Official Contact | 9543859711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Weston Medical Clinic Inc 17120 Royal Palm Blvd Suite 4 Weston FL 33326-2310 Ph: (954) 385-3711 | Weston Medical Clinic Inc 17120 Royal Palm Blvd Suite 4 Weston FL 33326-2310 Ph: (954) 385-3711 |
| NPI Number | 1609894484 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 08/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609894484 | NPI | - | NPPES |
| 255505100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0073727 (Florida) | Primary |
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