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Organization
PROVIDENCE HEALTH CENTER LLC
Active
Organization
PROVIDENCE HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUERLYNE DESIR ARNP (OWNER)
(954) 267-9696
Entity
Organization
Contact information
Practice address
1736 E COMMERCIAL BLVD, OAKLAND PARK, FL 33334-5721
(954) 267-9696
Mailing address
1736 E COMMERCIAL BLVD, OAKLAND PARK, FL 33334-5721
(954) 267-9696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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