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General NPI Number Information
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NPI Number | 1861039869
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Entity Type | Organization
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Legal Business Name | DIVERSE MULTI BILLING LLC
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Dates
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Enumeration Date | 12/09/2019
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 3646 NW 29TH CT
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311-8357
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Country | US
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Telephone | 954-200-4682
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26086
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City | TAMARAC
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State | FL
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Zip | 33320-6086
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ELENA DUROCHER
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Credential |
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Telephone | 954-200-4682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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