INJURY TREATMENT CENTER OF CORAL SPRINGS INC
Osteopathic Medicine at Oakland Park Blvd, Fort Lauderdale, FL

License number
Florida HCC3662
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: EVAN SADE
Title: CREDENTIALING DEPT
Phone: (954) 817-9402
Address
Address 2
871 W Oakland Park Blvd, Fort Lauderdale, FL 33311
2295 NW Corporate Blvd SUITE 140, Boca Raton, FL 33431
National Provider ID: 1396866653
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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INJURY TREATMENT CENTER OF CORAL SPRINGS, INC

Fort Lauderdale, FL  -  Boca Raton, FL

Industry:
General Hospital
Doing business as:
Injury Treatment Center of Coral
Registration:
Jul 17, 1997
Addresses:
4101 NW 4 St SUITE 206-8, Fort Lauderdale, FL 33317 (Physical)
2295 NW Corporate Blvd #140, Boca Raton, FL 33431 (Mailing)
871 W Oakland Park Blvd, Fort Lauderdale, FL 33311
2149 E Commercial Blvd, Fort Lauderdale, FL 33308
State ID:
P97000062298
Business type:
Florida Profit Corporation
Credentialing Depts:
Gary Brown (President), 2295 NW Corporate Blvd #140, Boca Raton, FL 33431 (Physical),Evan Sade (Credentialing Dept)
Agent:
Preferred Physicians Management Services, Inc,2295 NW Corporate Blvd STE 144, Boca Raton, FL 33431 (Physical)
EIN:
650770420

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