Healthcare Provider Details

I. General information

NPI: 1912525627
Provider Name (Legal Business Name): RONALDMCDONALD HOUSE CHARITIES SOUTH FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 NW 14TH TER
MIAMI FL
33136-1050
US

IV. Provider business mailing address

1145 NW 14TH TER
MIAMI FL
33136-1050
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-5683
  • Fax:
Mailing address:
  • Phone: 305-324-5683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: DAWN COMPRES
Title or Position: HOUSE MANAGER
Credential:
Phone: 305-324-5683