1821487737 NPI number — G & J ULTIMATE CARE NURSING SERVICES, LLC.

Table of content: (NPI 1821487737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821487737 NPI number — G & J ULTIMATE CARE NURSING SERVICES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G & J ULTIMATE CARE NURSING SERVICES, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821487737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 NE 199TH ST APT 101D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33179-3013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-454-0373
Provider Business Mailing Address Fax Number:
206-278-7124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99 NW 183RD ST STE 242A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33169-4502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-454-0373
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
VALERE
Authorized Official First Name:
GUERDA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
305-454-0373

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  30211758 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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