# PRIMARY CARE PRACTITIONERS OF SOUTH FLORIDA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356679989
- **Authorized official:** IVORY J CHRISTEN ARNP (VICE PRESIDENT)
- **Authorized official phone:** (954) 894-0522

## Contact information

- **Practice address:** 102 NE 2ND AVE, HALLANDALE BEACH, FL 33009-4212
- **Practice address phone:** (954) 894-0522
- **Practice address fax:** (954) 964-1244
- **Mailing address:** PO BOX 4110, HALLANDALE, FL 33008-4110
- **Mailing address phone:** (954) 894-0522
- **Mailing address fax:** (954) 455-4435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ARNP1714142 | FL | — |
| 208D00000X | General Practice Physician | ME0049240 | FL | Yes |
| 208D00000X | General Practice Physician | OS0001922 | FL | — |
| 208D00000X | General Practice Physician | OS0007497 | FL | — |

## Other

- **Enumeration date:** 11/19/2009
- **Last updated:** 11/19/2009