MEDICARE: MS. VONCILLE YVETTE DENSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372500000X	Chore Provider	233178	FL
2	372500000X	Chore Provider	006475500	FL
3	372600000X	Adult Companion	006475500	FL
4	3747A0650X	Attendant Care Provider
5	3747P1801X	Personal Care Attendant		FL
6	374U00000X	Home Health Aide	006475500-RES REHAB	FL
7	374U00000X	Home Health Aide
8	376J00000X	Homemaker	233178	FL
9	376J00000X	Homemaker	006475500	FL
10	372600000X	Adult Companion	233178	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003174798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VONCILLE YVETTE DENSON

Provider Business Mailing Address
First Line	:	PO BOX 14894
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32238-1894
Country	:	US
Telephone Number	:	904-437-4819
Fax Number	:	888-879-3207

Provider Business Practice Location Address
First Line	:	1408 STATE ST W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-7639
Country	:	US
Telephone Number	:	904-437-4819
Fax Number	:	888-879-3207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	02/27/2023

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Directions to “ MS. VONCILLE YVETTE DENSON ” Practice Location

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