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Organization

SACRED HEART MEDICAL HOME, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YVELICE ANTONIA VILLAMAN-BENCOSME (PRESIDENT)
(954) 392-0333
Entity
Organization

Contact information

Practice address
17901 NW 5TH ST, SUITE 205, PEMBROKE PINES, FL 33029-2810
(954) 392-0333
(954) 392-0393
Mailing address
17901 NW 5TH ST, SUITE 205, PEMBROKE PINES, FL 33029-2810
(954) 392-0333
(954) 392-0393

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME64482
FL

Other

Enumeration date
06/08/2007
Last updated
08/22/2020
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