Organization
THERAPEUTIC RECREATIONAL ACTIVITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY FALDEN (AMBR)
(954) 918-2164
Entity
Organization
Contact information
Practice address
221 N 46TH AVE, HOLLYWOOD, FL 33021-6603
(954) 873-0962
Mailing address
12335 NW 51ST ST, CORAL SPRINGS, FL 33076-3446
(954) 918-2164
(954) 369-4742
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP 2113432
FL
Other
Enumeration date
07/23/2015
Last updated
12/30/2015
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