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General NPI Number Information
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NPI Number | 1891120747
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Entity Type | Individual
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Provider Name | MS. NENILLA F. LAO
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Gender | Female
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 1012 GULF RD
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-2532
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Country | US
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Telephone | 727-938-0973
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Fax | 727-938-0973
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Provider Business Mailing Address
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Address Line | 1012 GULF RD
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-2532
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Country | US
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Telephone | 727-938-0973
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Fax | 727-938-0973
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL7977
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License Number State | FL
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