Provider Demographics
NPI:1699043539
Name:HIBISCUS CHILDREN'S CENTER
Entity Type:Organization
Organization Name:HIBISCUS CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:LOVELY
Authorized Official - Last Name:NOTTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-449-5483
Mailing Address - Street 1:664 SW 35TH STREET APT 4
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990
Mailing Address - Country:US
Mailing Address - Phone:561-449-5483
Mailing Address - Fax:
Practice Address - Street 1:664 SW 35TH ST APT 4
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-3659
Practice Address - Country:US
Practice Address - Phone:561-449-5483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health