Organization
NST FAMILY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JELLY WASHINGTON (MANAGER)
(954) 474-4401
Entity
Organization
Contact information
Practice address
600 S PINE ISLAND RD, SUITE 104, PLANTATION, FL 33324-3166
(954) 474-4401
Mailing address
600 SOUTH PINE ISLAND ROAD, SUITE 104, PLANTATION, FL 33324
(954) 474-4401
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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