=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437829561
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CYNTHIADANIELSHEAVENLYANGELSHELPINGHANDSLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2021
-----------------------------------------------------
Last Update Date | 09/20/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 MALTESE CIR APT 3
-----------------------------------------------------
City | FERN PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32730-2729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-860-3279
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 MALTESE CIR APT 3
-----------------------------------------------------
City | FERN PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32730-2729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-860-3279
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CYNTHIA DANIELS
-----------------------------------------------------
Credential | CERTIFIED NURSE
-----------------------------------------------------
Telephone | 407-860-3279
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------