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General NPI Number Information
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NPI Number | 1225585896
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Entity Type | Organization
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Legal Business Name | FABB SERVICES LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 2990 NW 203RD TER
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-1902
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Country | US
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Telephone | 786-417-8260
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Fax |
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Provider Business Mailing Address
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Address Line | 2990 NW 203 TERRACE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056
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Country | US
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Telephone | 786-417-8260
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. FLORENCE IBIERE BOOKER-SIMMONS
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Credential |
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Telephone | 786-417-8260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | 1-1154-GH
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License Number State | FL
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