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General NPI Number Information
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NPI Number | 1245053602
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Entity Type | Organization
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Legal Business Name | MAKENT LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 6750 N ANDREWS AVE STE 200
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2180
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Country | US
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Telephone | 267-853-8650
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 16203
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 954-544-1258
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ROSHELLA MARTIN
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Credential |
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Telephone | 954-544-1258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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