Provider Demographics
NPI:1831429612
Name:PALNNED PARENTHOOD OF SOUTH FLORIDA AND THE TREASURE COAST
Entity type:Organization
Organization Name:PALNNED PARENTHOOD OF SOUTH FLORIDA AND THE TREASURE COAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-472-9990
Mailing Address - Street 1:2300 N FLORIDA MANGO RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6416
Mailing Address - Country:US
Mailing Address - Phone:561-848-6402
Mailing Address - Fax:561-848-4461
Practice Address - Street 1:681 NE 125 STREET
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161
Practice Address - Country:US
Practice Address - Phone:786-621-0493
Practice Address - Fax:305-895-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL602571332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site