=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932080272
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOUNDATION FOR SICKLE CELL DISEASE RESEARCH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2025
-----------------------------------------------------
Last Update Date | 10/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1685 S STATE ROAD 7 STE 4
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-6721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-397-3251
-----------------------------------------------------
Fax | 954-374-6320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1685 S STATE ROAD 7 STE 4
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-6721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-397-3251
-----------------------------------------------------
Fax | 954-374-6320
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | LANETTA BRONTE
-----------------------------------------------------
Credential | MD, MPH, MSPH
-----------------------------------------------------
Telephone | 954-397-3251
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------