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Organization

BL MEDICAL CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LUIS G FERNANDEZ (CEO)
(954) 639-7738
Entity
Organization

Contact information

Practice address
9050 PINES BLVD STE 363, PEMBROKE PINES, FL 33024
(954) 639-7738
(954) 639-7735
Mailing address
9050 PINES BLVD STE 363, PEMBROKE PINES, FL 33024-6400
(954) 639-7738
(954) 639-7735

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
208D00000X
General Practice Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary
HCC11480
FL

Other

Enumeration date
05/29/2018
Last updated
08/29/2018
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