Provider Demographics
NPI:1346975752
Name:HAXMON MEDICAL SERVICES P LLC LLC
Entity type:Organization
Organization Name:HAXMON MEDICAL SERVICES P LLC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:BLEDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HAXHIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-651-7275
Mailing Address - Street 1:1007 N FEDERAL HWY # 381
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1422
Mailing Address - Country:US
Mailing Address - Phone:215-651-7275
Mailing Address - Fax:888-818-1230
Practice Address - Street 1:1201 N 37TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5414
Practice Address - Country:US
Practice Address - Phone:305-562-8090
Practice Address - Fax:888-818-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty