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General NPI Number Information
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NPI Number | 1346406394
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Entity Type | Organization
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Legal Business Name | EDNA'S ENTERPRISE
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 955 TUSKAWILLA RD
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4401
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Country | US
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Telephone | 321-262-8289
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Fax |
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Provider Business Mailing Address
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Address Line | 15383 NW 7TH AVE
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City | MIAMI
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State | FL
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Zip | 33169-6205
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Country | US
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Telephone | 321-262-8289
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALINE LAFORTUNE
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Credential |
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Telephone | 305-687-7714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 11382
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License Number State | FL
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