1811345440 NPI number — ABL CASE MANAGEMENT, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811345440 NPI number — ABL CASE MANAGEMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABL CASE MANAGEMENT, INC.
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:
1811345440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3389 SHERIDAN ST
Provider Second Line Business Mailing Address:
STE: 214
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33021-3606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-550-1653
Provider Business Mailing Address Fax Number:
866-516-2396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3389 SHERIDAN ST
Provider Second Line Business Practice Location Address:
STE: 214
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-3606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-550-1653
Provider Business Practice Location Address Fax Number:
866-516-2396
Provider Enumeration Date:
05/24/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BERTHOLD
Authorized Official First Name:
ROLAND
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/OWNER
Authorized Official Telephone Number:
800-550-1653

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  200915343 , 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: 251B00000X . This is a "MEDICAL CONSULTING CASE MANAGEMENT" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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