=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538463872
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NURSELETY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2010
-----------------------------------------------------
Last Update Date | 12/30/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19570 NW 82ND CT
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33015-5941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-491-3420
-----------------------------------------------------
Fax | 786-320-6418
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19570 NW ., 82 ND COURT
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-491-3420
-----------------------------------------------------
Fax | 786-320-6418
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGISTERED NURSE ADMINISTRATOR
-----------------------------------------------------
Name | MS. LETICIA SANCHEZ MENA SR.
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 305-491-3420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 9263617
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------