Provider Demographics
NPI:1891321097
Name:MADTEDAID INC
Entity Type:Organization
Organization Name:MADTEDAID INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ADELINE
Authorized Official - Last Name:EVEILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-646-8555
Mailing Address - Street 1:4580 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3701
Mailing Address - Country:US
Mailing Address - Phone:954-646-8555
Mailing Address - Fax:
Practice Address - Street 1:4580 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33309-3701
Practice Address - Country:US
Practice Address - Phone:954-646-8555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care