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NPI Code Detail

MEDICARE: MADTEDAID INC

MEDICARE: MADTEDAID 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1891321097
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADTEDAID INC
Provider Business Mailing Address
First Line : 4580 NW 17TH AVE
Second Line :
City : TAMARAC
State : FL
Zip : 33309-3701
Country : US
Telephone Number : 954-646-8555
Fax Number :
Provider Business Practice Location Address
First Line : 4580 NW 17TH AVE
Second Line :
City : TAMARAC
State : FL
Zip : 33309-3701
Country : US
Telephone Number : 954-646-8555
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MRS. MARIE ADELINE EVEILLARD
Credential : RN
Telephone Number : 954-646-8555
Provider Enumeration Date : 03/19/2020
Last Update Date : 03/19/2020

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Directions to “MADTEDAID INC ” Practice Location

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