1881721157 NPI number — FLORIDA OCCUPATIONAL HEALTHCARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881721157 NPI number — FLORIDA OCCUPATIONAL HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLORIDA OCCUPATIONAL HEALTHCARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881721157
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7860 SW 129TH TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINECREST
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33156-6154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-274-3311
Provider Business Mailing Address Fax Number:
305-274-1411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9000 SW 87TH CT
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33176-2231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-274-3311
Provider Business Practice Location Address Fax Number:
305-274-1411
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PEREDA
Authorized Official First Name:
ALEX
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT / PHYSIAL THERAPIST
Authorized Official Telephone Number:
305-274-3311

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT16622 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com