# 121 MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 121 MEDICAL CENTER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982384814
- **Legal business name:** 121 MEDICAL CENTER LLC
- **Authorized official:** ROSNY SIMEON (MANAGER)
- **Authorized official phone:** (561) 793-1475

## Contact information

- **Practice address:** 3333 W COMMERCIAL BLVD STE 110, FORT LAUDERDALE, FL 33309-3407
- **Practice address phone:** (954) 530-9770
- **Mailing address:** 11903 SOUTHERN BLVD STE 108, ROYAL PALM BEACH, FL 33411-7644
- **Mailing address phone:** (561) 793-1475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2023
- **Last updated:** 06/27/2025