Organization
G4 MEDICAL CENTERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AHMAD MORADI PHD (OWNER)
(954) 229-0900
Entity
Organization
Contact information
Practice address
2821 E COMMERCIAL BLVD, STE 201, FORT LAUDERDALE, FL 33308-4216
(954) 229-0204
Mailing address
2821 E COMMERCIAL BLVD, STE 201, FORT LAUDERDALE, FL 33308-4216
(954) 229-0204
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75804GM
TRIPLE S BC/BS OF P.R.
PR
01
—
R9700
BC BS OF FL
FL
Enumeration date
08/09/2005
Last updated
08/22/2020
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