# BL MEDICAL CENTER, INC

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

## Provider details

- **NPI number:** 1467943126
- **Authorized official:** LUIS G FERNANDEZ (CEO)
- **Authorized official phone:** (954) 639-7738

## Contact information

- **Practice address:** 9050 PINES BLVD STE 363, PEMBROKE PINES, FL 33024
- **Practice address phone:** (954) 639-7738
- **Practice address fax:** (954) 639-7735
- **Mailing address:** 9050 PINES BLVD STE 363, PEMBROKE PINES, FL 33024-6400
- **Mailing address phone:** (954) 639-7738
- **Mailing address fax:** (954) 639-7735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | HCC11480 | FL | Yes |

## Other

- **Enumeration date:** 05/29/2018
- **Last updated:** 08/29/2018