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NPI Code Detail

MEDICARE: BREEZEMONTE HOMES, INC.

MEDICARE: BREEZEMONTE HOMES, INC.
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
1251C00000XDevelopmentally Disabled Services Day Training Agency673902496FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720050644
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREEZEMONTE HOMES, INC.
Provider Business Mailing Address
First Line : 8246 LUCAYA CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6677
Country : US
Telephone Number : 904-622-8804
Fax Number :
Provider Business Practice Location Address
First Line : 8246 LUCAYA CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-6677
Country : US
Telephone Number : 904-622-8804
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. ALBERT MENEFEE
Credential :
Telephone Number : 904-622-8804
Provider Enumeration Date : 02/03/2006
Last Update Date : 08/19/2011

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Directions to “BREEZEMONTE HOMES, INC. ” Practice Location

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