| Act Florida, Llc | |
|
12505 Orange Dr Ste 908 Davie FL 33330-4300 | |
| (786) 306-0505 | |
| Not Available |
| Full Name | Act Florida, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12505 Orange Dr Ste 908, Davie, Florida |
| Authorized Official Name and Position | Yaimara Sanchez Caballero (MANAGER) |
| Authorized Official Contact | 7863060505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Act Florida, Llc 2413 Main St # 326 Miramar FL 33025-7809 Ph: (786) 306-0505 | Act Florida, Llc 12505 Orange Dr Ste 908 Davie FL 33330-4300 Ph: (786) 306-0505 |
| NPI Number | 1548860109 |
|---|---|
| Provider Enumeration Date | 10/31/2020 |
| Last Update Date | 10/31/2020 |
| Certification Date | 10/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548860109 | NPI | - | NPPES |
| 023444500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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