Healthcare Provider Details

I. General information

NPI: 1912918384
Provider Name (Legal Business Name): CITY OF DANIA BEACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W DANIA BEACH BLVD
DANIA BEACH FL
33004-3643
US

IV. Provider business mailing address

PO BOX 1708
DANIA BEACH FL
33004-1708
US

V. Phone/Fax

Practice location:
  • Phone: 954-924-3725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3219
License Number StateFL

VIII. Authorized Official

Name: KENNETH LAND
Title or Position: FIRE CHIEF
Credential:
Phone: 954-924-3725