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NPI Code Detail

MEDICARE: ELENA T TUDOR CNA

MEDICARE:   ELENA T TUDOR  CNA
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
1251E00000XHome Health Agency229629FL

General Provider Information

NPI Number : 1669245957
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELENA T TUDOR CNA
Provider Business Mailing Address
First Line : 1921 FLETCHER ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-6315
Country : US
Telephone Number : 954-662-4719
Fax Number :
Provider Business Practice Location Address
First Line : 1921 FLETCHER ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-6315
Country : US
Telephone Number : 954-662-4719
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2023
Last Update Date : 10/30/2023

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Directions to “ ELENA T TUDOR CNA” Practice Location

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