RACHAEL GITTENS MD LLC
Marriage and Family Therapists at Oakland Park Blvd, Fort Lauderdale, FL

License number
Florida ME86836
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DR. RACHAEL GITTENS M.D.
Title: PHYSICIAN
Phone: (954) 563-8600
Address
Address
1100 W Oakland Park Blvd UNIT 3, Fort Lauderdale, FL 33311
National Provider ID: 1679702278
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RACHAEL GITTENS MD LLC

1100 W Oakland Park Blvd, Fort Lauderdale, FL 33311

Status:
Inactive
Industry:
Family Doctor
Doing business as:
Rachael Gittens MD
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
May 20, 2008
Inactive since:
Sep 23, 2011
Phone:
(954) 563-8600 (Phone)
State ID:
L08000050230
Business type:
Florida Limited Liability Company
S:
Alwin Gittens, 1100 W Oakland Park Blvd, Fort Lauderdale, FL 33311 (Physical),Rachael Gittens, 1100 W Oakland Park Blvd, Fort Lauderdale, FL 33311 (Physical)
Agent:
Gittens, Alwin,1100 W Oakland Park Blvd, Fort Lauderdale, FL 33311 (Physical)
EIN:
262643822

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