Organization · NPI-2

Children'S Home Society Of Florida

Clinic/Center · Melbourne, FL

NPI number1619445087
StatusActive
Last updated in NPPESAug 3, 2021

Details

NPI
1619445087
Entity type
Organization (NPI-2)
Legal business name
Children'S Home Society Of Florida
Organization subpart
No
Enumeration date
Nov 5, 2018
Certification date
Aug 3, 2021
Last updated
Aug 3, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

326 Croton Rd
Melbourne, FL 32935-6340

Phone 321-752-3170

Mailing address

5766 S Semoran Blvd
Orlando, FL 32822-4818

Authorized official

Eileen Tosolini
Provider Relations Manager
3213975251

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