Organization
GENMAR'S HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA VIRGEN SANTAELLA NURSE (LPN)
(813) 679-9469
Entity
Organization
Contact information
Practice address
4784 HICKORY STREAM LN, MULBERRY, FL 33860-7914
(813) 679-9469
(863) 943-5201
Mailing address
4784 HICKORY STREAM LN, MULBERRY, FL 33860-7914
(813) 679-9469
(863) 943-5201
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194203471
—
FL
Enumeration date
08/26/2019
Last updated
08/26/2019
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