Provider Demographics
NPI:1609469972
Name:WRAPAROUND FLORIDDA
Entity Type:Organization
Organization Name:WRAPAROUND FLORIDDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHURIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-779-1613
Mailing Address - Street 1:5050 S US HIGHWAY 17/92 STE 106
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3863
Mailing Address - Country:US
Mailing Address - Phone:407-779-1613
Mailing Address - Fax:
Practice Address - Street 1:5050 S US HIGHWAY 17/92 STE 106
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3863
Practice Address - Country:US
Practice Address - Phone:407-779-1613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY ADVOCATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management