Ronald Fahrenholz

NPI #1194178038 in Tampa, Florida

Provider Information

NPI Number: 1194178038
Entity Type: Individual
Name: Ronald Fahrenholz
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jul 15, 2016
Last Updated: Jul 15, 2016

Practice Location

Address: 3809 N TAMPA ST
City: Tampa
State: Florida
ZIP Code: 33603-4743
Phone: (813) 872-6250

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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