Organization · NPI-2

5630 LLC

Internal Medicine · Fort Lauderdale, FL

NPI number1942022413
StatusActive
Last updated in NPPESOct 28, 2024

Details

NPI
1942022413
Entity type
Organization (NPI-2)
Legal business name
5630 LLC
Organization subpart
No
Enumeration date
Oct 28, 2024
Certification date
Oct 28, 2024
Last updated
Oct 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Other names

  • Sam Judah Sugar MD (Doing Business As)

Practice location

5630 Oaktree Ave
Fort Lauderdale, FL 33312-6375

Phone 847-571-4323

Mailing address

5630 Oaktree Ave
Fort Lauderdale, FL 33312-6375

Phone 847-571-4323

Authorized official

Sam Judah Sugar
Owner
8475714323

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