Organization · NPI-2

Broward Multispecialty Group LLC

Internal Medicine · Fort Lauderdale, FL

NPI number1306082227

StatusActive

Last updated in NPPESMar 15, 2010

Details

NPI: 1306082227
Entity type: Organization (NPI-2)
Legal business name: Broward Multispecialty Group LLC
Organization subpart: No
Enumeration date: Dec 23, 2008
Last updated: Mar 15, 2010

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
207VG0400X	Obstetrics & Gynecology, Gynecology	–	–
207RC0000X	Internal Medicine, Cardiovascular Disease	–	–
213E00000X	Podiatrist	–	–
207RG0300X	Internal Medicine, Geriatric Medicine	–	–
207RN0300X	Internal Medicine, Nephrology	–	–
208000000X	Pediatrics	–	–
207Q00000X	Family Medicine	–	–
207Y00000X	Otolaryngology	–	–
207RG0100X	Internal Medicine, Gastroenterology	–	–
207XS0106X	Orthopaedic Surgery, Hand Surgery	–	–
207RP1001X	Internal Medicine, Pulmonary Disease	–	–
207RE0101X	Internal Medicine, Endocrinology, Diabetes & Metabolism	–	–
208600000X	Surgery	–	–
207W00000X	Ophthalmology	–	–

Practice location

1625 Se 3rd Ave
Suite 400
Fort Lauderdale, FL 33316-2521

Phone 954-832-0058 · Fax 954-832-0262

Mailing address

401 E Las Olas Blvd
Suite 130-137
Fort Lauderdale, FL 33301-2210

Phone 954-616-3627 · Fax 954-414-8453

Authorized official

Gabrielle Finley-Hazle
Chief Executive Officer
9546163627

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