Provider Demographics
NPI:1679827448
Name:PLANNED PARENTHOOD OF SOUTH FLORIDA AND THE TREASURE COAST
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF SOUTH FLORIDA AND THE TREASURE COAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-472-9990
Mailing Address - Street 1:2300 N FL MANGO RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6416
Mailing Address - Country:US
Mailing Address - Phone:561-848-6402
Mailing Address - Fax:561-472-9979
Practice Address - Street 1:1322 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1004
Practice Address - Country:US
Practice Address - Phone:772-692-2024
Practice Address - Fax:772-692-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL602626332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site