Healthcare Provider Details

I. General information

NPI: 1124757398
Provider Name (Legal Business Name): MADISON PAIGE HUNT CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 06/06/2022
Certification Date: 06/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 SW ARCHER RD
GAINESVILLE FL
32608-1316
US

IV. Provider business mailing address

14 SW 8TH PL APT 202
WILLISTON FL
32696-2940
US

V. Phone/Fax

Practice location:
  • Phone: 352-554-2000
  • Fax:
Mailing address:
  • Phone: 352-529-7331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number420045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: