Healthcare Provider Details

I. General information

NPI: 1528089760
Provider Name (Legal Business Name): CONNER INDUSTRIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 SW 5TH CT
POMPANO BEACH FL
33060-7910
US

IV. Provider business mailing address

160 SW 5TH CT
POMPANO BEACH FL
33060-7910
US

V. Phone/Fax

Practice location:
  • Phone: 954-564-7026
  • Fax: 954-564-8938
Mailing address:
  • Phone: 954-564-7026
  • Fax: 954-564-8938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: JASON M CONNER
Title or Position: PRESIDENT
Credential:
Phone: 954-564-7026