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General NPI Number Information
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NPI Number | 1336937036
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Entity Type | Organization
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Legal Business Name | OUR LOVED ONES AGENCY LLC
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2598 E SUNRISE BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3230
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Country | US
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Telephone | 954-873-8235
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Fax |
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Provider Business Mailing Address
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Address Line | 2598 E SUNRISE BLVD STE 2104
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3230
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Country | US
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Telephone | 954-873-8235
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOUBENTHA DESSE
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Credential |
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Telephone | 954-873-8235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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