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General NPI Number Information
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NPI Number | 1386188209
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Entity Type | Organization
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Legal Business Name | NURSE CARE REGISTRY
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 837 NE 20TH AVE SUITE 102
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3035
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Country | US
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Telephone | 754-701-5225
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Fax | 754-701-5231
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Provider Business Mailing Address
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Address Line | 837 NE 20TH AVE SUITE 102
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3035
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Country | US
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Telephone | 754-701-5225
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Fax | 754-701-5231
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRADLEY THOMAS DANYLUK
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Credential |
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Telephone | 754-701-5225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IN PROCESS
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License Number State | FL
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