MEDICARE: NONA HARDAMAN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	251E00000X	Home Health Agency	FL
2	385HR2065X	Child Physical Disabilities Respite Care	FL
3	253Z00000X	In Home Supportive Care Agency
4	376J00000X	Homemaker	FL
5	385H00000X	Respite Care
6	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care	FL

General Provider Information

NPI Number	:	1669055455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NONA HARDAMAN

Provider Business Mailing Address
First Line	:	2485 W 30TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-3407
Country	:	US
Telephone Number	:	904-235-7278
Fax Number	:

Provider Business Practice Location Address
First Line	:	2485 W 30TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-3407
Country	:	US
Telephone Number	:	904-235-7278
Fax Number	:

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

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	04/30/2021

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Directions to “ NONA HARDAMAN ” Practice Location

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