Provider Demographics
NPI:1225040827
Name:CITY OF PLANTATION
Entity type:Organization
Organization Name:CITY OF PLANTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PUDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-797-2150
Mailing Address - Street 1:PO BOX 918557
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 NW 73RD AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1609
Practice Address - Country:US
Practice Address - Phone:954-797-2150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3244341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL590011521OtherRAILROAD PROVIDER ID
FL400040400Medicaid
FLA0700Medicare ID - Type UnspecifiedMEDICARE NUMBER