Provider Demographics
NPI:1295571271
Name:APALACHEE DIGITAL LLC
Entity type:Organization
Organization Name:APALACHEE DIGITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-647-0191
Mailing Address - Street 1:2320 E MARINA BAY DR APT 308
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-2335
Mailing Address - Country:US
Mailing Address - Phone:954-647-0191
Mailing Address - Fax:
Practice Address - Street 1:2320 E MARINA BAY DR APT 308
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-2335
Practice Address - Country:US
Practice Address - Phone:954-647-0191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty