1700562345 NPI number — A.K. & FRIENDS LLC

Table of content: (NPI 1700562345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700562345 NPI number — A.K. & FRIENDS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A.K. & FRIENDS LLC
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:
ATTE SPORTS ORTHO CONSULTS
Provider Other Organization Name Type Code:
3
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:
1700562345
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7950 SW 30TH ST STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVIE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33328-1979
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
754-356-8300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7950 SW 30TH ST STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33328-1979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-200-8571
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2023

Additional Information

Authorized Official

Authorized Official Last Name:
ATTE
Authorized Official First Name:
AKERE
Authorized Official Middle Name:
CHONGWAIN
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
412-200-8571

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 118687800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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