DONALD DIXON MD PA.
Ambulatory Health at Sheridan St, Hollywood, FL

License number
Florida ME49983
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. DONALD DIXON MD.
Title: OWNER
Phone: (954) 985-0774
Address
Address
7261 Sheridan St STE 100, Hollywood, FL 33024
National Provider ID: 1811352420
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DONALD DIXON, M.D., PA

7261 Sheridan St SUITE 100, Hollywood, FL 33024

Status:
Inactive
Industry:
Medical Doctor's Office, Pediatrician
Inactive reason:
REINSTATEMENT
Registration:
Nov 5, 1999
Inactive since:
Nov 26, 2012
State ID:
P99000097929
Business type:
Florida Profit Corporation
Director:
Donald Dixon (Director), 11113 Topeka Pl, Hollywood, FL 33026 (Physical)
Agent:
Bernstein, Mark,2131 Hollywood Blvd, Hollywood, FL 33020 (Physical)
EIN:
65-0964360

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