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Organization
PHOENIX CLINIC INC OF BROWARD
Active
Organization
PHOENIX CLINIC INC OF BROWARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE GRAHAM (CHIEF EXECUTIVE OFFICER)
(305) 891-3439
Entity
Organization
Contact information
Practice address
2212 SW 60TH TERRACE, MIRAMAR, FL 33023
(954) 491-2133
(954) 491-2344
Mailing address
2212 SW 60TH TERRACE, MIRAMAR, FL 33023
(954) 491-2133
(954) 491-2344
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1006AD354501
FL
Other
Enumeration date
07/03/2006
Last updated
08/08/2011
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