Healthcare Provider Details

I. General information

NPI: 1750618690
Provider Name (Legal Business Name): ATENDA NURSING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 SCOTT STREET
HOLLYWOOD FL
33020
US

IV. Provider business mailing address

2510 SCOTT ST
HOLLYWOOD FL
33020-2357
US

V. Phone/Fax

Practice location:
  • Phone: 305-305-3857
  • Fax: 954-923-3205
Mailing address:
  • Phone: 305-305-3857
  • Fax: 954-923-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number15426398
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number311Z00000X
License Number StateFL

VIII. Authorized Official

Name: SHERLY BOURSIQUOT
Title or Position: SOCIAL WORKER
Credential: BSW
Phone: 305-305-3857