Provider Demographics
NPI:1407570930
Name:MACE, EUGENE
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:
Last Name:MACE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 SOUTHWEST 3RD PLACE
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004
Mailing Address - Country:US
Mailing Address - Phone:954-651-5035
Mailing Address - Fax:
Practice Address - Street 1:257 SOUTHWEST 3RD PLACE
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004
Practice Address - Country:US
Practice Address - Phone:954-651-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker