Provider Demographics
NPI:1245836055
Name:PRIORITY HEALTH 770 INC
Entity type:Organization
Organization Name:PRIORITY HEALTH 770 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:ADAYAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALMARAL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:239-200-1716
Mailing Address - Street 1:7130 NW 45TH CT
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7130 NW 45TH CT
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4066
Practice Address - Country:US
Practice Address - Phone:239-200-1716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care