Healthcare Provider Details

I. General information

NPI: 1326425695
Provider Name (Legal Business Name): MIRACLES CAN HAPPEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 NW 62ND ST STE 300
FORT LAUDERDALE FL
33309-1953
US

IV. Provider business mailing address

1451 NW 62ND ST STE 300
FORT LAUDERDALE FL
33309-1953
US

V. Phone/Fax

Practice location:
  • Phone: 954-446-7416
  • Fax:
Mailing address:
  • Phone: 954-446-7416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: DRINA ARTESIA WILSON
Title or Position: CO-OWNER
Credential: M.S.
Phone: 965-446-7416