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General NPI Number Information
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NPI Number | 1982868626
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Entity Type | Organization
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Legal Business Name | CHT PROVIDER LLC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 8701 SW 14TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-3344
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Country | US
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Telephone | 954-435-2484
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Fax | 954-435-8379
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Provider Business Mailing Address
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Address Line | 8701 SW 14TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-3344
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Country | US
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Telephone | 954-435-2484
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Fax | 954-435-8379
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | LUCIE ROBITAILLE
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Credential | OT
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Telephone | 954-435-2484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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