Basic Information
| Provider Information | |||||||||
| NPI: | 1801091764 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AIDS HEALTHCARE FOUNDATION | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AHF MCO | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 SE 6TH ST | ||||||||
| Address2: | SUITE 1960 | ||||||||
| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333015000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545223132 | ||||||||
| FaxNumber: | 9545223260 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 SE 6TH ST | ||||||||
| Address2: | SUITE 1960 | ||||||||
| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333015000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545223132 | ||||||||
| FaxNumber: | 9545223260 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STIDHAM | ||||||||
| AuthorizedOfficialFirstName: | DONNA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OF MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 9545223132 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | R.N. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | Y | Managed Care Organizations | Health Maintenance Organization |
No ID Information.