Healthcare Provider Details

I. General information

NPI: 1740572239
Provider Name (Legal Business Name): MEDI-BILL PLUS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 NW 28TH ST
OAKLAND PARK FL
33311-2116
US

IV. Provider business mailing address

PO BOX 17244
PLANTATION FL
33318-7244
US

V. Phone/Fax

Practice location:
  • Phone: 954-336-3310
  • Fax:
Mailing address:
  • Phone: 954-336-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MIYOSHI AGNEW
Title or Position: CEO
Credential: CBCS
Phone: 954-336-3310