Organization Name: | SARAH DODGE INC |
NPI Number: | 1104150523 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SARAH D MORRISON (PRESIDENT) |
Mailing Address: | 8206 Nw 103rd St Hialeah Gardens |
State: | FL US |
Postal Code: | 330162202 |
Phone Number: | 3053623162 |
Fax Number: | 3053623252 |
NPI Enumeration Date: | 10/02/2009 |
NPI Last Update Date: | 10/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | ME81343 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |