Provider Demographics
NPI:1104065770
Name:HANDICAPPED DRIVER SERVICES-FLORIDA, LLC
Entity type:Organization
Organization Name:HANDICAPPED DRIVER SERVICES-FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-200-1379
Mailing Address - Street 1:4199 KINROSS LAKES PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9394
Mailing Address - Country:US
Mailing Address - Phone:234-312-2000
Mailing Address - Fax:330-659-0876
Practice Address - Street 1:750 E SAMPLE RD STE 3
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5144
Practice Address - Country:US
Practice Address - Phone:954-942-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WV0202X, 332B00000X, 320900000X
FL332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment