Canyon Gate Medical Group Llc

LBN: Canyon Gate Medical Group Llc
Canyon Gate Medical Group Llc is an health care organization with primary practice located at 2929 N. University Dr. Suite # 110, Coral Springs FL 33065-5081. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Canyon Gate Medical Group Llc can be contacted via phone (954) 656-8855, or through Moskow, Ricki via phone (954) 656-8855.

Contact Information

Primary practice address
2929 N. University Dr. Suite # 110 Coral Springs FL 33065-5081
Fax: (954) 656-8855
Website:
Authorized official contact:
Name: Moskow, Ricki

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 12804 Nevada

Profile Details

NPI number 1598085797
LBN Legal business name Canyon Gate Medical Group Llc
DBA Doing business as
Authorized official Moskow, Ricki
Entity Organization
Organization subpart 1 No
Enumeration date Jun 10th, 2010
Last updated Jun 10th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598085797 NPPES
Nevada MEDICAID 1831347731

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