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General NPI Number Information
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NPI Number | 1902218449
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Entity Type | Organization
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Legal Business Name | SHICK SHADEL OF FLORIDA LLC
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 5960 SW 106TH ST
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City | COOPER CITY
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State | FL
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Zip | 33328-6410
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Country | US
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Telephone | 954-680-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 5960 SW 106TH ST
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City | COOPER CITY
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State | FL
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Zip | 33328-6410
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Country | US
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Telephone | 954-680-2700
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Fax |
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Authorized Official
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Title or Position | SR VP CFO
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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