MEDICARE: UNITED CEREBRAL PALSY 0F BROWARD, PALM BEACH AND MID-COAST COUNTIES, INC.

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
1	171W00000X	Contractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710855622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED CEREBRAL PALSY 0F BROWARD, PALM BEACH AND MID-COAST COUNTIES, INC.

Provider Business Mailing Address
First Line	:	3117 SW 13TH CT
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-2714
Country	:	US
Telephone Number	:	954-584-7178
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 SW 13TH CT
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-2714
Country	:	US
Telephone Number	:	954-584-7178
Fax Number	:

Authorized Official
Title or Position	:	COORDINATOR OF PROGRAM SUPPORTS
Name	:	KAREN KNOBLOCK
Credential	:
Telephone Number	:	305-728-1551

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	01/08/2026

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