=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548526148
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APEX DEDICATED SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2012
-----------------------------------------------------
Last Update Date | 04/09/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2941 N NOB HILL RD APT 208
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33322-5876
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-638-2787
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2941 N NOB HILL RD APT 208
-----------------------------------------------------
City | SUNRISE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33322-5876
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | YUBIRI ROMERO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 954-638-2787
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------