Provider Demographics
NPI:1013348218
Name:FLORIDA HOME EDUCATION PROGRAM
Entity Type:Organization
Organization Name:FLORIDA HOME EDUCATION PROGRAM
Other - Org Name:SCHOOL CODE 7224
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLADSTONE
Authorized Official - Middle Name:WOLFGANG
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-217-5152
Mailing Address - Street 1:7300 SW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3875
Mailing Address - Country:US
Mailing Address - Phone:786-217-5152
Mailing Address - Fax:305-742-2740
Practice Address - Street 1:7300 SW 167TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-3875
Practice Address - Country:US
Practice Address - Phone:786-217-5152
Practice Address - Fax:305-742-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)