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General NPI Number Information
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NPI Number | 1487245403
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Entity Type | Organization
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Legal Business Name | CLOUD 9 PPEC, LLC
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 15407 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33177-1279
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Country | US
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Telephone | 786-385-1748
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Fax |
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Provider Business Mailing Address
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Address Line | 15407 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33177-1279
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Country | US
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Telephone | 786-385-1748
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Fax |
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Authorized Official
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Title or Position | MNG
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Name | AMANDA RODRIGUEZ
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Credential |
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Telephone | 786-385-1748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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