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General NPI Number Information
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NPI Number | 1902213226
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Entity Type | Organization
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Legal Business Name | NEVAEH HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 4615 SW 25TH ST
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City | WEST PARK
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State | FL
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Zip | 33023-4305
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Country | US
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Telephone | 954-629-8712
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Fax |
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Provider Business Mailing Address
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Address Line | 4615 SW 25TH ST
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City | WEST PARK
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State | FL
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Zip | 33023-4305
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Country | US
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Telephone | 954-629-8712
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Fax |
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Authorized Official
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Title or Position | MGRM
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Name | NICKEITA RODRIGUEZ
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Credential |
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Telephone | 954-629-8712
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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 | 233608
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License Number State | FL
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