Provider Demographics
NPI:1992969828
Name:HOSPITALIST M D ASSOCIATES LLC
Entity type:Organization
Organization Name:HOSPITALIST M D ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-885-4299
Mailing Address - Street 1:PO BOX 279425
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-9425
Mailing Address - Country:US
Mailing Address - Phone:954-885-4299
Mailing Address - Fax:954-885-4298
Practice Address - Street 1:10021 PINES BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6191
Practice Address - Country:US
Practice Address - Phone:954-885-4299
Practice Address - Fax:954-885-4298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL906Medicare PIN