Provider Demographics
NPI:1376946533
Name:ARC SOUTH OF FLORIDA
Entity Type:Organization
Organization Name:ARC SOUTH OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YUSELMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CABALLERO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:786-298-4246
Mailing Address - Street 1:25911 SW 143RD CT APT 833
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8954
Mailing Address - Country:US
Mailing Address - Phone:786-298-4246
Mailing Address - Fax:
Practice Address - Street 1:756 W PALM DR
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-3224
Practice Address - Country:US
Practice Address - Phone:305-246-3530
Practice Address - Fax:305-246-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency