Provider Demographics
NPI:1154644482
Name:BROWARD COUNTY RYAN WHITE PART A OFFICE
Entity Type:Organization
Organization Name:BROWARD COUNTY RYAN WHITE PART A OFFICE
Other - Org Name:COMMUNITY PARTNERSHIP DIVISION
Other - Org Type:Other Name
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-357-8647
Mailing Address - Street 1:115 S ANDREWS AVE
Mailing Address - Street 2:A-300
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1818
Mailing Address - Country:US
Mailing Address - Phone:954-357-5390
Mailing Address - Fax:954-357-5897
Practice Address - Street 1:115 S ANDREWS AVE
Practice Address - Street 2:A-300
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1818
Practice Address - Country:US
Practice Address - Phone:954-357-5390
Practice Address - Fax:954-357-5897
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF BROWARD COUNTY COMMISIONERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare