Organization
BROWARD INTEGRATIVE MEDICAL LLC
Active
Parent organization
BROWARD INTEGRATIVE MEDICAL
Other names
Broward Integrative Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROWARD INTEGRATIVE MEDICAL
Authorized official
MR. RAINFORD POYSER APRN (OWNER)
(754) 218-7163
Entity
Organization
Contact information
Practice address
1749 NE 26TH ST STE E, WILTON MANORS, FL 33305-1428
(754) 218-7163
Mailing address
1749 NE 26TH ST STE E, WILTON MANORS, FL 33305-1428
(754) 218-7163
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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