Organization
MEDICUS HEALTH PLAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO M LOPEZ-IVERN MD (OWNER / M.D)
(866) 731-6777
Entity
Organization
Contact information
Practice address
9980 CENTRAL PARK BLVD N STE 116, BOCA RATON, FL 33428-1703
(866) 731-6777
(954) 845-0416
Mailing address
9980 CENTRAL PARK BLVD N STE 116, BOCA RATON, FL 33428-1703
(866) 731-6777
(954) 845-0416
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036593
OUTPATIENT DETOXIFICATION
FL
Enumeration date
10/25/2018
Last updated
10/25/2018
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