Provider Demographics
NPI:1104114339
Name:THE KEY CLUBHOUSE OF SOUTH FLORIDA, INC.
Entity type:Organization
Organization Name:THE KEY CLUBHOUSE OF SOUTH FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SOLOVEI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:305-374-5115
Mailing Address - Street 1:260 NE 17TH TER
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1194
Mailing Address - Country:US
Mailing Address - Phone:305-374-5115
Mailing Address - Fax:305-374-5113
Practice Address - Street 1:260 NE 17TH TER
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1194
Practice Address - Country:US
Practice Address - Phone:305-374-5115
Practice Address - Fax:305-374-5113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage