Organization
INFIRMACARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONTAE WALDEN LPN (CEO)
(305) 834-5390
Entity
Organization
Contact information
Practice address
3711 NW 21ST ST APT 307, LAUDERDALE LAKES, FL 33311-3158
(305) 834-5390
Mailing address
3711 NW 21ST ST APT 307, LAUDERDALE LAKES, FL 33311-3158
(305) 834-5390
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251F00000X
Home Infusion Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
—
—
335G00000X
Medical Foods Supplier
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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