Individual
MR. JIMMY LEE EAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PERSONAL CARE
Contact information
Practice address
12771 PALMER CIR, TAMPA, FL 33612-2500
(813) 297-5345
Mailing address
12771 PALMER CIR, TAMPA, FL 33612-2500
(813) 297-5345
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
0489
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002169700
—
FL
Enumeration date
11/01/2011
Last updated
07/21/2022
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