Organization
HAMPTON'S LUXURY VILLAS INC
Active
Organization
HAMPTON'S LUXURY VILLAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENNIE CARIAS WITHERUP (PRESIDENT/CEO)
(904) 536-3091
Entity
Organization
Contact information
Practice address
10695 HAMPTON RD, JACKSONVILLE, FL 32257-6905
(904) 232-8575
(904) 328-3850
Mailing address
10695 HAMPTON RD, JACKSONVILLE, FL 32257-6905
(904) 232-8575
(904) 328-3850
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
AL#12086
FL
261QH0100X
Health Service Clinic/Center
Primary
AL#12086
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004569900
—
FL
Enumeration date
04/27/2012
Last updated
04/27/2012
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