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Organization
REVELATION FAMILY MEDICINE OFFICE, LLC.
Active
Organization
REVELATION FAMILY MEDICINE OFFICE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEAN-MARCEL FORTE PA-C (CERTIFIED PHYSICIAN ASSISTANT)
(305) 807-4283
Entity
Organization
Contact information
Practice address
3939 HOLLYWOOD BLVD STE 300B, HOLLYWOOD, FL 33021-6749
(786) 863-8633
Mailing address
3939 HOLLYWOOD BLVD STE 300B, HOLLYWOOD, FL 33021-6749
(786) 863-8633
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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