Individual
IKESHA FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20525 NW 24TH AVE, MIAMI GARDENS, FL 33056-1531
(786) 263-8004
Mailing address
20525 NW 24TH AVE, MIAMI GARDENS, FL 33056-1531
(786) 263-8004
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
FL
253Z00000X
In Home Supportive Care Agency
Primary
—
FL
374U00000X
Home Health Aide
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNA429942
NURSING ASSISTANT
FL
Enumeration date
03/07/2022
Last updated
01/23/2023
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