Healthcare Provider Details

I. General information

NPI: 1225046733
Provider Name (Legal Business Name): 440 MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 PHIPPEN WAITERS RD
DANIA BEACH FL
33004-4931
US

IV. Provider business mailing address

4700 SHERIDAN ST SUITE B
HOLLYWOOD FL
33021-3420
US

V. Phone/Fax

Practice location:
  • Phone: 954-927-0508
  • Fax: 954-927-3127
Mailing address:
  • Phone: 954-367-4563
  • Fax: 954-367-4564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1119096
License Number StateFL

VIII. Authorized Official

Name: MS. MARGARET FERNANDEZ I
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 954-367-4563