1447232657 NPI number — ALL WOMENS HEALTHCARE OF DADE INC

Table of content: (NPI 1447232657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447232657 NPI number — ALL WOMENS HEALTHCARE OF DADE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL WOMENS HEALTHCARE OF DADE INC
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:
1447232657
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 452375
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNRISE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33345-2375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-838-2565
Provider Business Mailing Address Fax Number:
954-839-1960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 NW 170TH ST
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33169-5513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-653-0550
Provider Business Practice Location Address Fax Number:
305-653-0909
Provider Enumeration Date:
11/15/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DROZDOW
Authorized Official First Name:
GILBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-838-2371

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 367A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 269058600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".