Contract Details
Ancillary Care Services
Facility name
Plantation Physical Medicine
Provider ID
P000005931
Tax ID
352448106
Effective Date
9/27/2012
Last Updated
9/30/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
8267 West Sunrise Boulevard
Plantation, FL 33322
United States
County
Broward
Phone
9545776161 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Rehabilitation Facility
Map
Address