Organization
BANANA WIND MEDICAL GROUP, L.L.C
Active
Other names
Dynamik Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC LEE SHAVER R.N. (DIRECTOR OF NURSING)
(321) 315-3601
Entity
Organization
Contact information
Practice address
11335 COMMERCIAL ST, ORLANDO, FL 32836-6216
(407) 259-8731
Mailing address
35 W PINE ST, SUITE 218, ORLANDO, FL 32801-2610
(407) 259-8731
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN9246384
FL
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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