Healthcare Provider Details

I. General information

NPI: 1205720059
Provider Name (Legal Business Name): LATOYA S. BREWER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W MAIN ST # 1011
LEESBURG FL
34748-5128
US

IV. Provider business mailing address

711 W MAIN ST # 1011
LEESBURG FL
34748-5128
US

V. Phone/Fax

Practice location:
  • Phone: 689-278-5758
  • Fax: 689-219-6288
Mailing address:
  • Phone: 689-278-5758
  • Fax: 689-219-6288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: LATOYA SHARMAINE BREWER
Title or Position: OWNER
Credential: CNA
Phone: 689-278-5758