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Organization

PROVIDENCE COMMUNITY MEDICAL CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GUERLYNE DESIR ARNP (VP)
(954) 267-9696
Entity
Organization

Contact information

Practice address
1736 E COMMERCIAL BLVD, OAKLAND PARK, FL 33334-5721
(954) 267-9696
Mailing address
1736 E COMMERCIAL BLVD, OAKLAND PARK, FL 33334-5721
(954) 267-9696

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
FL

Other

Enumeration date
11/18/2016
Last updated
11/18/2016
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