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General NPI Number Information
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NPI Number | 1487169785
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Entity Type | Organization
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Legal Business Name | HONRANDO NUESTRAS CANAS LLC.
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 1845 ALTERNATE S27
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City | LAKE HAMILTON
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State | FL
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Zip | 33851
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Country | US
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Telephone | 863-812-3961
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5109
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City | HAINES CITY
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State | FL
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Zip | 33845-5109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MRG
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Name | MRS. ANA LUISA GONZALEZ CRUZ
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Credential |
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Telephone | 863-812-3961
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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 |
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License Number State | FL
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