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Individual

MISS OLIVE MAUREEN LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA/PCA

Contact information

Practice address
4421 NW 37TH ST, LAUDERHILL, FL 33319-5511
(954) 538-4831
Mailing address
4421 NW 37TH ST, LAUDERHILL, FL 33319-5511
(954) 538-4831

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA 34317
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
686049496
MED WAIVER
FL
Enumeration date
04/13/2011
Last updated
04/13/2011
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