MEDICARE: DEPENDABLE NIGHTINGALES AGENCY, INC.

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	251E00000X	Home Health Agency	22007096	FL

General Provider Information

NPI Number	:	1992980874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPENDABLE NIGHTINGALES AGENCY, INC.

Provider Business Mailing Address
First Line	:	499 STATE ROAD 434
Second Line	:	SUITE 2125
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2170
Country	:	US
Telephone Number	:	407-862-0439
Fax Number	:	407-386-3464

Provider Business Practice Location Address
First Line	:	499 STATE ROAD 434
Second Line	:	SUITE 2125
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2170
Country	:	US
Telephone Number	:	407-862-0439
Fax Number	:	407-386-3464

Authorized Official
Title or Position	:	CEO/POSITION
Name	:	MR. DAVID FENENBOCK
Credential	:
Telephone Number	:	407-733-6497

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	07/21/2016

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