Organization
INPHYNET SOUTH BROWARD LLC
Active
Other names
InPhyNet South Broward Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D CORVINI MD (PRESIDENT)
(813) 635-5855
Entity
Organization
Contact information
Practice address
3501 JOHNSON STREET, HOLLYWOOD, FL 33021-3302
(954) 987-2000
Mailing address
PO BOX 635002, CINCINNATI, OH 45263-5002
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170128100
US DEPT OF LABOR
FL
01
—
170128101
US DEPT
FL
01
—
21223
BS FL
FL
05
—
251537700
—
FL
05
—
251537701
—
FL
05
—
251537702
—
FL
05
—
251537703
—
FL
05
—
251537704
—
FL
05
—
251537705
—
FL
01
—
CD7742
MEDICARE TRAVELERS RR - G
FL
Enumeration date
06/29/2006
Last updated
09/10/2020
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