IMPACT FOR DEVELOPMENTAL EDUCATION INC NPI 1760525539

NPI Information

NPI: 1760525539
Provider Name: IMPACT FOR DEVELOPMENTAL EDUCATION, INC
Classification: Voluntary or Charitable - 251V00000X
Entity Type: Organization
Address:
1650 MEDICAL LANE STE 4
FORT MYERS, FL
ZIP 33907
Phone: (239) 334-6160
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IMPACT FOR DEVELOPMENTAL EDUCATION, INC is a voluntary or charitable in Fort Myers, FL. IMPACT FOR DEVELOPMENTAL EDUCATION, INC NPI is 1760525539. The provider is registered as an organization entity type.

The provider's business location address is:

1650 MEDICAL LANE STE 4
FORT MYERS, FL
ZIP 33907-116
Phone: (239) 334-6160
Fax: (239) 334-1339

The provider's authorized official is Madeline Bravo .
The authorized official title is Program Director and has the following contact phone number (239) 334-6160.

The enumeration date for this NPI number is 2/14/2007 and was last updated on 11/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251V00000X	Voluntary or Charitable				Yes
2	261Q00000X	Clinic/Center				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	811806000	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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