Provider Demographics
NPI:1851566723
Name:ROBERT AND CHRISTINE CUNNINGHAM, LLC
Entity Type:Organization
Organization Name:ROBERT AND CHRISTINE CUNNINGHAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:305-664-0146
Mailing Address - Street 1:PO BOX 702
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-0702
Mailing Address - Country:US
Mailing Address - Phone:305-664-0146
Mailing Address - Fax:
Practice Address - Street 1:140 PORTO SALVO DR
Practice Address - Street 2:
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3319
Practice Address - Country:US
Practice Address - Phone:305-664-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2376251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health