Organization
BRIDGE DISABILITY NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY EBANKS-NUNAIHED DPT (VP OF THERAPY SERVICES)
(954) 699-4690
Entity
Organization
Contact information
Practice address
500 N PARK RD, HOLLYWOOD, FL 33021-6905
(954) 894-9023
Mailing address
500 N PARK RD, HOLLYWOOD, FL 33021-6905
(954) 894-9023
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
SA10164
FL
261QP2000X
Physical Therapy Clinic/Center
Primary
PT27161
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002014300
—
FL
05
—
008612500
—
FL
Enumeration date
05/13/2014
Last updated
05/13/2014
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