Memorial Medical Group of South Florida, LLC

NPI #1336806801 in Hollywood, Florida

Provider Information

NPI Number: 1336806801
Entity Type: Organization
Organization Name: Memorial Medical Group of South Florida, LLC
Primary Specialty: Physician Assistant
Enumeration Date: Nov 19, 2021
Last Updated: Nov 19, 2021

Practice Location

Address: 4000 HOLLYWOOD BLVD STE 555S
City: Hollywood
State: Florida
ZIP Code: 33021-6853
Phone: (754) 273-0885

Authorized Official

Name: MS. LISA B MARSHALL, DMSC, PAC
Title: MEDICAL DIRECTOR
Phone: (754) 273-0885

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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