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NPI 1083990543 - Contractor - 171W00000X

NPI Details
NPI 1083990543
Enumeration Date 10/28/2011
Last Updated 10/28/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name BRIDGETTE BRIDGETTE
Position PRESIDENT
Phone (305) 904-9033
Fax
Practice Location
15711 SW 20TH ST
MIRAMAR FL, 33027-4204, US
Phone (305) 904-9033
Fax
Business Location
15711 SW 20TH ST
MIRAMAR FL, 33027-4204, US
Phone (305) 904-9033
Fax
Toxanomy
Taxonomy Code 171W00000X
License State
License Number
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According to our database, Bln NPI is 1083990543, taxonomy code is 171W00000X Bln physically located at 15711 Sw 20th St, Miramar FL, 33027-4204. NPI Number 1033115704 has the healthcare provider type.

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1083990543 NPI number is provided on an as is basis without warranty of any kind. 1083990543 is maintained by the National Plan & Provider Enumeration System. The contents of Bln are for informational purposes only.