1649281924 NPI number — CITY OF FORT LAUDERDALE

Table of content: (NPI 1649281924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649281924 NPI number — CITY OF FORT LAUDERDALE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF FORT LAUDERDALE
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:
CITY OF FORT LAUDERDALE FIRE RESCUE
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:
1649281924
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 31076
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33631-3076
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
528 NW 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33311-1162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-828-6847
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOLLAN
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
954-828-6800

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3234 , 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: 590013949 . This is a "RAILROAD PROVIDER ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 400063300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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