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General NPI Number Information
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NPI Number | 1891561494
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Entity Type | Organization
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Legal Business Name | FRATERNITY HEALTH SERVICES, INC
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 14707 S DIXIE HWY STE 402B
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7954
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Country | US
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Telephone | 305-850-0508
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Fax |
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Provider Business Mailing Address
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Address Line | 14707 S DIXIE HWY STE 402B
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7954
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Country | US
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Telephone | 305-850-0508
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. IGNACIO M PLASENCIA
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Credential |
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Telephone | 305-850-0508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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