Basic Information
| Provider Information | |||||||||
| NPI: | 1417543109 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TENET FLORIDA PHYSICIAN SERVICES II, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 BAYVIEW DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333061772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545671332 | ||||||||
| FaxNumber: | 5615372721 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 BAYVIEW DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333061772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545671332 | ||||||||
| FaxNumber: | 5615372721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2020 | ||||||||
| LastUpdateDate: | 01/13/2021 | ||||||||
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| AuthorizedOfficialLastName: | RASMUS | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP, CFO TENET PHYSICIAN RESOURCES | ||||||||
| AuthorizedOfficialTelephone: | 4698932532 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.