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General NPI Number Information
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NPI Number | 1891522470
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Entity Type | Organization
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Legal Business Name | PDP MD, LLC
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1004 NW 51ST PL STE 3500
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3140
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Country | US
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Telephone | 888-776-5958
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Fax |
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Provider Business Mailing Address
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Address Line | 101 WORLD DR STE 200
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-6980
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Country | US
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Telephone | 888-776-5958
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | BENJAMIN FAINO
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Credential |
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Telephone | 908-514-6619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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