Organization
BETHESDA MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIBU VARUGHESE (MEDICAL DIRECTOR)
(504) 265-8304
Entity
Organization
Contact information
Practice address
11050 GRIFFIN RD STE 104, DAVIE, FL 33328-3227
(954) 824-1922
(954) 824-1922
Mailing address
11050 GRIFFIN RD STE 104, DAVIE, FL 33328-3227
(954) 824-1922
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
Other
Enumeration date
01/08/2019
Last updated
03/18/2026
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