1952351348 NPI number — DR. RONALD ANDREW FORD M.D.

Table of content: DR. RONALD ANDREW FORD M.D. (NPI 1952351348)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952351348 NPI number — DR. RONALD ANDREW FORD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORD
Provider First Name:
RONALD
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1952351348
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1117 E HALLANDALE BEACH BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HALLANDALE BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33009-4488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-457-8771
Provider Business Mailing Address Fax Number:
954-266-4006

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3501 JOHNSON ST
Provider Second Line Business Practice Location Address:
DIVISION OF PEDIATRICS, INPATIENT
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-5421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-265-6301
Provider Business Practice Location Address Fax Number:
954-985-1434
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME82570 , 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)

  • Identifier: 261569000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 019435600 . 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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