Organization
MEDWIN PA
Active
Other names
Medwin Clinicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICAH BOAZ EDWIN MD (PRESIDENT)
(786) 214-2001
Entity
Organization
Contact information
Practice address
4850 W OAKLAND PARK BLVD STE 224, LAUDERDALE LAKES, FL 33313-7261
(786) 214-2001
Mailing address
PO BOX 4067, FT LAUDERDALE, FL 33338-4067
(786) 214-2001
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/06/2020
Last updated
04/08/2021
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