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General NPI Number Information
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NPI Number | 1972599017
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Entity Type | Organization
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Legal Business Name | MEDERI OF CORAL SPRINGS, INC
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10011 PINES BLVD SUITE 203D
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6189
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Country | US
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Telephone | 305-668-9020
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Fax | 305-661-4910
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Provider Business Mailing Address
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Address Line | PO BOX 144536
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City | CORAL GABLES
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State | FL
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Zip | 33114-4536
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Country | US
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Telephone | 305-668-9020
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Fax | 305-661-4910
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID A NESSLEIN
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Credential |
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Telephone | 305-668-9020
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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 | FL
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