Provider Demographics
NPI:1548695307
Name:TENET FLORIDA PHYSICIAN SERVICES III, LLC
Entity type:Organization
Organization Name:TENET FLORIDA PHYSICIAN SERVICES III, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP REGIONAL OPERATIONS, TENET
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-509-3671
Mailing Address - Street 1:9960 CENTRAL PARK BLVD N
Mailing Address - Street 2:STE 400
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1759
Mailing Address - Country:US
Mailing Address - Phone:561-288-5530
Mailing Address - Fax:561-482-1469
Practice Address - Street 1:6245 N FEDERAL HWY
Practice Address - Street 2:STE 300
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1998
Practice Address - Country:US
Practice Address - Phone:561-288-5530
Practice Address - Fax:561-482-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty