Healthcare Provider Details

I. General information

NPI: 1588802672
Provider Name (Legal Business Name): CMA HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 EXECUTIVE PARK DR
WESTON FL
33331-3624
US

IV. Provider business mailing address

2645 EXECUTIVE PARK DR
WESTON FL
33331-3624
US

V. Phone/Fax

Practice location:
  • Phone: 954-641-9586
  • Fax: 954-337-3322
Mailing address:
  • Phone: 954-641-9586
  • Fax: 954-337-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number30211377
License Number StateFL

VIII. Authorized Official

Name: DR. CRAIG DONNER
Title or Position: ADMINISTRATOR
Credential: D.C.
Phone: 954-641-9586