Provider Demographics
NPI:1578006672
Name:CONSUMER SUPPORT NETWORK, LTD. CO.
Entity type:Organization
Organization Name:CONSUMER SUPPORT NETWORK, LTD. CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-FRANCOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-546-9007
Mailing Address - Street 1:1175 NE 125TH STREET
Mailing Address - Street 2:SUITE 313
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161
Mailing Address - Country:US
Mailing Address - Phone:305-981-0300
Mailing Address - Fax:305-981-0500
Practice Address - Street 1:1175 NE 125TH ST
Practice Address - Street 2:SUITE 313
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5015
Practice Address - Country:US
Practice Address - Phone:305-981-0300
Practice Address - Fax:305-981-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016471500Medicaid