Organization
PEMBROKE VILLAGE MEDICAL CENTER INC
Active
Other names
Century Village Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT D CAMERLINCK (PRESIDENT)
(561) 745-3877
Entity
Organization
Contact information
Practice address
13550 SW 10TH ST, PEMBROKE PINES, FL 33027-6445
(954) 435-6001
(954) 435-6137
Mailing address
250 S. CENTRAL BLVD, SUITE 207, JUPITER, FL 33458
(561) 745-3877
(561) 745-3866
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA777A
PTAN
FL
Enumeration date
02/05/2009
Last updated
12/29/2014
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