Organization
SOURCE MEDICAL GROUP, LLC
Active
Organization
SOURCE MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY GARR (AMBR)
(215) 570-8300
Entity
Organization
Contact information
Practice address
208 SE 8TH ST, FT LAUDERDALE, FL 33316-1014
(561) 704-6781
Mailing address
7601 N FEDERAL HWY STE 245A, BOCA RATON, FL 33487-1672
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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