Individual
GWENDOLYN CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7735 PLANTATION BAY DR APT 406, JACKSONVILLE, FL 32244-5190
(904) 477-9934
Mailing address
7735 PLANTATION BAY DR APT 406, JACKSONVILLE, FL 32244-5190
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42
MEDICAID
FL
Enumeration date
07/11/2019
Last updated
07/11/2019
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