Provider Demographics
NPI:1568283893
Name:SOUTH FLORIDA PRIMARY HEALTHCARE
Entity type:Organization
Organization Name:SOUTH FLORIDA PRIMARY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TYSHARRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELFON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-412-1150
Mailing Address - Street 1:1360 NW 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5341
Mailing Address - Country:US
Mailing Address - Phone:786-412-1150
Mailing Address - Fax:
Practice Address - Street 1:8053 W OAKLAND PARK BLVD STE 600
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-1159
Practice Address - Country:US
Practice Address - Phone:786-412-1150
Practice Address - Fax:478-202-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-19
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty