Basic Information
| Provider Information | |||||||||
| NPI: | 1467967695 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CLEVELAND CLINIC FLORIDA CONCIERGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6801 BRECKSVILLE RD | ||||||||
| Address2: | STE 20, RK2-7 | ||||||||
| City: | INDEPENDENCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2166364969 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1301 E BROWARD BLVD STE 305 | ||||||||
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| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333012152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662937866 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2017 | ||||||||
| LastUpdateDate: | 03/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | HARRINGTON | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF ACCOUNTING OFFICER/CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 2164458990 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CLEVELAND CLINIC FLORIDA HEALTH SYSTEM NONPROFIT CORPORATION | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.