Provider Demographics
NPI:1114265451
Name:PLANNED PARENTHOOD OF SOUTH FLORIDA AND THE TREASURE COAST
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF SOUTH FLORIDA AND THE TREASURE COAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-472-9990
Mailing Address - Street 1:2300 N FL MANGO RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6416
Mailing Address - Country:US
Mailing Address - Phone:561-848-6402
Mailing Address - Fax:561-472-9979
Practice Address - Street 1:7900 NW 27TH AVE
Practice Address - Street 2:STE 240
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:305-423-7933
Practice Address - Fax:786-517-6138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL604749332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site