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General NPI Number Information
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NPI Number | 1760516397
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Entity Type | Organization
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Legal Business Name | SEMBRANDO FLORES
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 162 SW 1ST AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-7008
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Country | US
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Telephone | 305-247-2438
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Fax | 786-601-2483
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Provider Business Mailing Address
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Address Line | 815 N HOMESTEAD BLVD #616
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City | HOMESTEAD
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State | FL
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Zip | 33030-5024
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Country | US
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Telephone | 305-247-2438
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. NANCY RIVERA-TIDWELL
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Credential |
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Telephone | 305-247-2438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 113AD549401
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License Number State | FL
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