Organization
PINE CREST SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF JOHNSON (ATHLETIC DIRECTOR)
(954) 776-2134
Entity
Organization
Contact information
Practice address
1501 NE 62ND ST, FT LAUDERDALE, FL 33334-5116
(954) 776-2134
(954) 492-4562
Mailing address
1501 NE 62ND ST, FT LAUDERDALE, FL 33334-5116
(954) 776-2134
(954) 492-4562
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
AL1707
FL
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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