Organization
FITNESS MADE FUN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JORDANA BETH FAINE SIADMAN MSPT (OWNER)
(954) 661-5695
Entity
Organization
Contact information
Practice address
1634 POINSETTIA DR, FORT LAUDERDALE, FL 33305-3245
(954) 661-5695
(954) 568-0682
Mailing address
1634 POINSETTIA DR, FORT LAUDERDALE, FL 33305-3245
(954) 661-5695
(954) 568-0682
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PT 19480
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891911900
—
FL
Enumeration date
05/03/2007
Last updated
03/04/2009
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