1699984831 NPI number — ROYAL PALM KIDS CARE

Table of content: DAVID N COLLINS (NPI 1346648482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699984831 NPI number — ROYAL PALM KIDS CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYAL PALM KIDS CARE
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:
1699984831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2825 N STATE ROAD 7
Provider Second Line Business Mailing Address:
SUITE #305
Provider Business Mailing Address City Name:
MARGATE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33063-5737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-752-8700
Provider Business Mailing Address Fax Number:
954-752-0509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2825 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
SUITE #305
Provider Business Practice Location Address City Name:
MARGATE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33063-5737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-752-8700
Provider Business Practice Location Address Fax Number:
954-752-0509
Provider Enumeration Date:
05/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RODRIGUEZ
Authorized Official First Name:
DAGOBERTO
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-752-8700

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME0058463 , 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: ME0058463 . This is a "LICENSE#" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 265743100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010900500 . 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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