1730661216 NPI number — SOUTH FLORIDA THERAPY FOR FAMILIES PLLC

Table of content: (NPI 1215078126)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730661216 NPI number — SOUTH FLORIDA THERAPY FOR FAMILIES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH FLORIDA THERAPY FOR FAMILIES PLLC
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:
6
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:
1730661216
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5550 GLADES ROAD
Provider Second Line Business Mailing Address:
STE 500
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431-7277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-271-7104
Provider Business Mailing Address Fax Number:
561-501-5481

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5550 GLADES ROAD
Provider Second Line Business Practice Location Address:
STE 500
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33431-7277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-271-7104
Provider Business Practice Location Address Fax Number:
561-501-5481
Provider Enumeration Date:
08/31/2018

Additional Information

Authorized Official

Authorized Official Last Name:
BERGER
Authorized Official First Name:
MONICA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/MBR
Authorized Official Telephone Number:
561-271-7104

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW14660 , 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)





Copyright © 2007-2025 www.npivalidator.com