Healthcare Provider Details

I. General information

NPI: 1780122754
Provider Name (Legal Business Name): KINSEY'S HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 W JASMINE DR
LAKE PARK FL
33403-2108
US

IV. Provider business mailing address

920 W JASMINE DR
LAKE PARK FL
33403-2108
US

V. Phone/Fax

Practice location:
  • Phone: 561-891-4694
  • Fax:
Mailing address:
  • Phone: 561-891-4694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GINA C KINSEY
Title or Position: OWNER/ RN
Credential: RN9425797
Phone: 561-891-4694