Organization
BISCUP INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLYDE H FREDRICKSON III (CFO)
(954) 355-4088
Entity
Organization
Contact information
Practice address
1301 E BROWARD BLVD, SUITE 300, FORT LAUDERDALE, FL 33301-2135
(954) 355-4088
(954) 355-4089
Mailing address
1301 E BROWARD BLVD, SUITE 300, FORT LAUDERDALE, FL 33301-2135
(954) 355-4088
(954) 355-4089
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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