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NPI Code Detail

MEDICARE: EXCEPTIONAL DEVELOPMENT CORP. OF SOUTH FLORIDA

MEDICARE: EXCEPTIONAL DEVELOPMENT CORP. OF SOUTH FLORIDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1343900000XNon-emergency Medical Transport (VAN)FL
2251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1649466806
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCEPTIONAL DEVELOPMENT CORP. OF SOUTH FLORIDA
Provider Business Mailing Address
First Line : 991 NW 54TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33127-1817
Country : US
Telephone Number : 305-758-9910
Fax Number : 305-758-9929
Provider Business Practice Location Address
First Line : 991 NW 54TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33127-1817
Country : US
Telephone Number : 305-758-9910
Fax Number : 305-758-9929
Authorized Official
Title or Position : CEO
Name : MR. MICHAEL S. FAINE
Credential :
Telephone Number : 305-758-9910
Provider Enumeration Date : 09/21/2007
Last Update Date : 09/21/2007

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Directions to “EXCEPTIONAL DEVELOPMENT CORP. OF SOUTH FLORIDA ” Practice Location

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