Organization
CLINIQUE MEDMANAGEMENT GROUP, LLC
Active
Other names
La Clinique Soleil
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRO BACCHELLI JR. M.D. (M.D./OWNER)
(954) 342-8800
Entity
Organization
Contact information
Practice address
750 S FEDERAL HWY, HOLLYWOOD, FL 33020-5424
(954) 342-8800
Mailing address
750 S FEDERAL HWY, HOLLYWOOD, FL 33020-5424
(954) 342-8800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34696
BCBS
FL
Enumeration date
11/28/2007
Last updated
06/03/2013
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