Provider Demographics
NPI:1720334287
Name:PREVAIL HEALTHCARE OF FL
Entity Type:Organization
Organization Name:PREVAIL HEALTHCARE OF FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-271-6421
Mailing Address - Street 1:2817 E OAKLAND PARK BLVD
Mailing Address - Street 2:STE 201F
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1889
Mailing Address - Country:US
Mailing Address - Phone:954-271-6421
Mailing Address - Fax:888-821-1696
Practice Address - Street 1:2817 E OAKLAND PARK BLVD
Practice Address - Street 2:STE 201F
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1889
Practice Address - Country:US
Practice Address - Phone:954-271-6421
Practice Address - Fax:888-821-1696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994022251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health