Provider Demographics
NPI:1174826796
Name:UNITED CEREBRAL PALSY
Entity type:Organization
Organization Name:UNITED CEREBRAL PALSY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED RESPIRATORY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-423-5611
Mailing Address - Street 1:16521 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6001
Mailing Address - Country:US
Mailing Address - Phone:305-947-7461
Mailing Address - Fax:
Practice Address - Street 1:16521 NW 1ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6001
Practice Address - Country:US
Practice Address - Phone:305-947-7261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT10744302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization