Provider Demographics
NPI:1063158202
Name:TRI-COUNTY MEDICAL CARE , LLC
Entity type:Organization
Organization Name:TRI-COUNTY MEDICAL CARE , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-707-1955
Mailing Address - Street 1:3156 INVERNESS
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1816
Mailing Address - Country:US
Mailing Address - Phone:954-707-1955
Mailing Address - Fax:
Practice Address - Street 1:4420 SHERIDAN ST STE A
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3552
Practice Address - Country:US
Practice Address - Phone:954-888-4223
Practice Address - Fax:954-874-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty