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Individual

MR. DAVID CHRISTOPHER WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4623 EBONY ST, ORLANDO, FL 32811-3823
(407) 990-6333
(321) 206-4502
Mailing address
4623 EBONY ST, ORLANDO, FL 32811-3823
(407) 990-6333
(321) 206-4502

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
003905100
FL
251E00000X
Home Health Agency
007902900
FL
310400000X
Assisted Living Facility
FL
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
FL
372600000X
Adult Companion
376J00000X
Homemaker
232909
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007902900
FL
Enumeration date
07/25/2011
Last updated
02/10/2016
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