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General NPI Number Information
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NPI Number | 1487232799
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Entity Type | Individual
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Provider Name | LATRICA M CHANCE CNA MED TECH CARGIV
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 3350 E ATLANTIC BLVD STE 209
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City | POMPANO BEACH
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State | FL
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Zip | 33062-5743
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Country | US
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Telephone | 954-258-3714
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 NE 6TH ST UNIT 2324
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City | POMPANO BEACH
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State | FL
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Zip | 33061-2614
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Country | US
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Telephone | 954-951-7899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 406578
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | NULL
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | NULL
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Taxonomy #5
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 406578
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 409579
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License Number State | FL
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