Organization
PELICAN PALACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINETTE ALEXANDER DNP (ADMINISTRATOR)
(954) 709-6545
Entity
Organization
Contact information
Practice address
12335 NW 51ST ST, CORAL SPRINGS, FL 33076-3446
(954) 709-6545
(954) 369-4742
Mailing address
12335 NW 51ST ST, CORAL SPRINGS, FL 33076-3446
(954) 709-6545
(954) 369-4742
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FL
—
FL
Enumeration date
12/13/2015
Last updated
12/13/2015
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