Individual
HERTAYZIA ESHAY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3019 NE 20TH WAY, GAINESVILLE, FL 32609-3395
(352) 283-3287
Mailing address
1415 SE 42ND PL, GAINESVILLE, FL 32641-9268
(352) 283-3287
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
87-3080428
FL
376J00000X
Homemaker
Primary
87-3080428
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87-3080428
COMPANIONSHIP & HOMEMAKER
FL
Enumeration date
11/03/2021
Last updated
11/03/2021
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