Provider Demographics
NPI:1295348159
Name:EASTER SEALS SOUTH FLORIDA, INC.
Entity type:Organization
Organization Name:EASTER SEALS SOUTH FLORIDA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVERANGA BARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-547-4745
Mailing Address - Street 1:1475 NW 14 AVE.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-325-0470
Mailing Address - Fax:305-325-0578
Practice Address - Street 1:301 NW 103RD AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-6010
Practice Address - Country:US
Practice Address - Phone:954-450-6855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTER SEALS SOUTH FLORIDA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-28
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health