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Individual

LEONIE EVADNEY BOOTHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
80 NE 166 STREET, MIAMI, FL 33162
(305) 947-1439
(305) 947-1439
Mailing address
26 NE 110 STREET, MIAMI, FL 33161
(305) 947-1439
(305) 947-1439

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
CNA82954
FL
310400000X
Assisted Living Facility
Primary
A9211
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141080600
FL
Enumeration date
10/29/2012
Last updated
09/15/2022
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