Individual
TEQUESTA DUKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1713 W MARSHALL LAKE DR, APOPKA, FL 32703-1622
(407) 692-5471
Mailing address
PO BOX 1929, APOPKA, FL 32704-1929
(407) 692-5471
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010514400
—
FL
Enumeration date
03/11/2020
Last updated
03/11/2020
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