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General NPI Number Information
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NPI Number | 1700188679
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Entity Type | Organization
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Legal Business Name | MYHYLANDERS ELDERCARE, LLC
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 5668 GULF BREEZE PKWY SUITE B-12
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City | GULF BREEZE
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State | FL
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Zip | 32563-9524
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Country | US
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Telephone | 850-203-1670
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Fax | 850-203-1674
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Provider Business Mailing Address
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Address Line | 5668 GULF BREEZE PKWY SUITE B-12
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City | GULF BREEZE
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State | FL
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Zip | 32563-9524
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Country | US
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Telephone | 850-203-1670
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Fax | 850-203-1674
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LYNDA R HYLAND
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Credential |
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Telephone | 850-203-1670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | NR30211252
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License Number State | FL
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