Individual
AMONISE MONDESTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 CYPRESS KNEE DR, BOCA RATON, FL 33487-2116
(561) 853-5260
Mailing address
4600 CYPRESS KNEE DR, BOCA RATON, FL 33487-2116
(561) 853-5260
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
6907014
FL
311ZA0620X
Adult Care Home Facility
Primary
6907014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106070200
—
FL
01
—
255059
CERTIFY NURSING ASSISTANT
FL
01
—
6907014
ADULT FAMILY CARE HOME
FL
Enumeration date
08/07/2020
Last updated
08/07/2020
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