Healthcare Provider Details

I. General information

NPI: 1700141744
Provider Name (Legal Business Name): FLORENCE MOFOR HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7613 NEWBURG DR
LANHAM MD
20706-4610
US

IV. Provider business mailing address

7506 GEORGIA AVE NW
WASHINGTON DC
20012-1608
US

V. Phone/Fax

Practice location:
  • Phone: 301-592-7536
  • Fax:
Mailing address:
  • Phone: 202-291-6973
  • Fax: 202-291-7018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200004562
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: