Organization
PHYSICIANS CLINICAL RESEARCH ALLIANCE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT S GORDON (COO)
(954) 656-8855
Entity
Organization
Contact information
Practice address
2825 N STATE ROAD 7, SUITE 204, MARGATE, FL 33063-5737
(954) 935-1477
(954) 935-1422
Mailing address
2825 N STATE ROAD 7, SUITE 204, MARGATE, FL 33063-5737
(954) 935-1477
(954) 935-1422
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40029
MEDICRE PTAN
—
Enumeration date
07/24/2008
Last updated
07/24/2008
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