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General NPI Number Information
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NPI Number | 1619426392
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Entity Type | Organization
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Legal Business Name | TUNLAB HOME HEALTH AGENCY INC.
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 6724 CAMELIA DRIVE
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City | MIRAMAR
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State | FL
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Zip | 33023
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Country | US
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Telephone | 754-246-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 6724 CAMELIA DR
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City | MIRAMAR
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State | FL
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Zip | 33023-4847
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Country | US
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Telephone | 754-246-8437
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. OLATUNJI O BANKOLE
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Credential |
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Telephone | 305-331-7697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 20080
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License Number State | FL
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