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LEDDATALIZ PEDROGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
4762 BREEZER DR, LAKE WALES, FL 33859-5447
(407) 724-4853
Mailing address
1615 ELLINGTON DR, DUNDEE, FL 33838-4633
(407) 724-4853

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5198865
FL
251E00000X
Home Health Agency
PN5198865
FL
251J00000X
Nursing Care Agency
PN5198865
FL
261QD1600X
Developmental Disabilities Clinic/Center
PN5198865
FL
372600000X
Adult Companion
PN5198865
FL
376K00000X
Nurse's Aide
PN5198865
FL
385H00000X
Respite Care
PN5198865
FL
385HR2055X
Child Mental Illness Respite Care
PN5198865
FL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
PN5198865
FL
385HR2065X
Child Physical Disabilities Respite Care
PN5198865
FL

Other

Enumeration date
03/30/2012
Last updated
07/21/2022
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