MEDICARE: SENTINEL NURSING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1629268685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENTINEL NURSING, LLC

Provider Business Mailing Address
First Line	:	12800 UNIVERSITY DR
Second Line	:	SUITE 275
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5332
Country	:	US
Telephone Number	:	239-590-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	12800 UNIVERSITY DR
Second Line	:	SUITE 275
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5332
Country	:	US
Telephone Number	:	239-590-9066
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAIME G VILLABLANCA
Credential	:
Telephone Number	:	239-590-9066

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	07/26/2007

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