Provider Demographics
NPI:1386259166
Name:WEST DIXIE MEDICAL STAFFING LLC
Entity type:Organization
Organization Name:WEST DIXIE MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CFO
Authorized Official - Prefix:
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-431-0790
Mailing Address - Street 1:11820 MIRAMAR PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5817
Mailing Address - Country:US
Mailing Address - Phone:954-431-0790
Mailing Address - Fax:954-212-5855
Practice Address - Street 1:11820 MIRAMAR PKWY STE 201
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5817
Practice Address - Country:US
Practice Address - Phone:954-431-0790
Practice Address - Fax:954-212-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health