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Organization
FAMILY MEDICAL GROUP HOLLYWOOD, LLC
Active
Organization
FAMILY MEDICAL GROUP HOLLYWOOD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZSANDRA RODRIGUEZ (OWNER)
(954) 324-4080
Entity
Organization
Contact information
Practice address
3800 JOHNSON ST STE G, HOLLYWOOD, FL 33021-6030
(954) 324-4080
Mailing address
3800 JOHNSON ST STE G, HOLLYWOOD, FL 33021-6030
(954) 324-4080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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