Provider Demographics
NPI:1700857208
Name:CMS FT. LAUDERDALE
Entity Type:Organization
Organization Name:CMS FT. LAUDERDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMEY-KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-713-3105
Mailing Address - Street 1:1625 SE 3RD AVE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2521
Mailing Address - Country:US
Mailing Address - Phone:954-713-3105
Mailing Address - Fax:
Practice Address - Street 1:1625 SE 3RD AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-713-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare