Provider Demographics
NPI:1619306446
Name:KING DAVID FOUNDATION INC
Entity Type:Organization
Organization Name:KING DAVID FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MS,PHD
Authorized Official - Phone:305-935-6726
Mailing Address - Street 1:17971 BISCAYNE BLVD STE 117
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2531
Mailing Address - Country:US
Mailing Address - Phone:305-935-6726
Mailing Address - Fax:305-931-3643
Practice Address - Street 1:17971 BISCAYNE BLVD STE 117
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2531
Practice Address - Country:US
Practice Address - Phone:305-935-6726
Practice Address - Fax:305-931-3643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251K00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251K00000XAgenciesPublic Health or Welfare