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General NPI Number Information
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NPI Number | 1477250074
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Entity Type | Organization
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Legal Business Name | KEYS ISLAND NURSE CORP
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 94825 OVERSEAS HWY UNIT 255
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City | KEY LARGO
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State | FL
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Zip | 33037-3898
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Country | US
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Telephone | 786-647-8736
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Fax |
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Provider Business Mailing Address
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Address Line | 94825 OVERSEAS HWY UNIT 255
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City | KEY LARGO
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State | FL
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Zip | 33037-3898
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Country | US
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Telephone | 786-647-8736
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAXI MARTINEZ
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Credential | R.N.
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Telephone | 786-647-8736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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