Individual
MS. AWILDA THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 BELVEDERE RD STE 300E, WEST PALM BEACH, FL 33406-1554
(561) 507-1601
(561) 214-6139
Mailing address
1601 BELVEDERE RD STE 300E, WEST PALM BEACH, FL 33406-1554
(561) 507-1601
(561) 214-6139
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
30212801
FL
251F00000X
Home Infusion Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30212801
NURSE REGISTRY LICENSED
FL
01
—
L24000107190
LLC
FL
Enumeration date
05/30/2018
Last updated
08/23/2024
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