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General NPI Number Information
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NPI Number | 1790449429
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Entity Type | Organization
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Legal Business Name | HOLDING FATE SERVICES LLC
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 3750 W 16TH AVE STE 232U
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City | HIALEAH
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State | FL
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Zip | 33012-4648
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Country | US
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Telephone | 305-316-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 3750 W 16TH AVE STE 232U
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City | HIALEAH
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State | FL
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Zip | 33012-4648
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Country | US
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Telephone | 305-316-9080
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | PABLO CEPERO ABREU
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Credential |
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Telephone | 786-366-3519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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