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General NPI Number Information
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NPI Number | 1295348159
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Entity Type | Organization
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Legal Business Name | EASTER SEALS SOUTH FLORIDA, INC.
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 301 NW 103RD AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-6010
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Country | US
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Telephone | 954-450-6855
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Fax |
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Provider Business Mailing Address
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Address Line | 1475 NW 14 AVE.
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City | MIAMI
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State | FL
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Zip | 33125
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Country | US
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Telephone | 305-325-0470
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Fax | 305-325-0578
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | NICOLE ALVERANGA BARHAM
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Credential |
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Telephone | 305-547-4745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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