Individual
KENYA ALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1317 WOOD LAKE CIR, SAINT CLOUD, FL 34772-7467
(407) 593-2621
Mailing address
1317 WOOD LAKE CIR, SAINT CLOUD, FL 34772-7467
(912) 432-5254
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
FL
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
237380
FL
376J00000X
Homemaker
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108873400
—
FL
01
—
237380
AHCA - HOMEMAKER COMPANION
FL
Enumeration date
07/30/2021
Last updated
06/21/2022
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