Organization
BROWARD MEDICAL & URGENT CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN M ROCHE MD (MEDICAL DIRECTOR)
(954) 462-7558
Entity
Organization
Contact information
Practice address
103 SE 20TH ST, FT LAUDERDALE, FL 33316-2846
(954) 462-7558
(954) 525-5820
Mailing address
103 SE 20TH ST, SUITE 100, FT LAUDERDALE, FL 33316-2846
(954) 462-7558
(954) 525-5820
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME13408
FL
261QU0200X
Urgent Care Clinic/Center
Primary
ME13408
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06962
BCBS OF FLORIDA
FL
01
—
AD067Y
PTAN MEDICARE
FL
Enumeration date
05/11/2007
Last updated
07/15/2014
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