Healthcare Provider Details
I. General information
NPI: 1639703903
Provider Name (Legal Business Name): PAM AND ASSOCIATES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2020
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1931 NW 150TH AVE STE 208
PEMBROKE PINES FL
33028-2879
US
IV. Provider business mailing address
1931 NW 150TH AVE STE 208
PEMBROKE PINES FL
33028-2879
US
V. Phone/Fax
- Phone: 954-612-2555
- Fax:
- Phone: 954-961-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 222Q00000X |
| Taxonomy | Developmental Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARIE-ANDREE
P
FRANCOIS
Title or Position: REGISTERED DIETITIAN NUTRITIONIST
Credential: RDN LDN
Phone: 954-961-5700