=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932797677
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DENNMARC INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2021
-----------------------------------------------------
Last Update Date | 05/30/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18710 SW 107TH AVE UNIT 11
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-6750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-514-9236
-----------------------------------------------------
Fax | 786-549-6400
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20771 SW 87TH CT
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33189-7378
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DENNISE HAUGHTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-393-8681
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------