Provider Demographics
NPI:1114937422
Name:CITY OF LAUDERHILL
Entity Type:Organization
Organization Name:CITY OF LAUDERHILL
Other - Org Name:CITY OF LAUDERHILL FIRE RESCUE
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:E
Authorized Official - Last Name:CELETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-730-2950
Mailing Address - Street 1:PO BOX 22318
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-2318
Mailing Address - Country:US
Mailing Address - Phone:954-730-2950
Mailing Address - Fax:954-730-2955
Practice Address - Street 1:1980 NW 56TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-4060
Practice Address - Country:US
Practice Address - Phone:954-730-2950
Practice Address - Fax:954-730-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL400037400Medicaid
FL590011522OtherRAILROAD PROVIDER ID
FLA0697OtherPART B MEDICARE #
FLA0697Medicare ID - Type UnspecifiedMEDICARE NUMBER