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General NPI Number Information
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NPI Number | 1851863948
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Entity Type | Individual
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Provider Name | MS. NATALEE LUBOLD
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Gender | Female
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Dates
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Enumeration Date | 12/30/2018
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 1189 NW SOPHIE DR
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City | WHITE SPRINGS
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State | FL
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Zip | 32096-7430
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Country | US
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Telephone | 386-269-2275
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 SW CENTRAL TER
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City | FORT WHITE
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State | FL
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Zip | 32038-4667
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Country | US
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Telephone | 386-269-2755
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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