Provider Demographics
NPI:1063504520
Name:SPECIALIZED NURSING SERVICES INC
Entity Type:Organization
Organization Name:SPECIALIZED NURSING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:IX
Authorized Official - Credentials:
Authorized Official - Phone:305-652-2799
Mailing Address - Street 1:17011 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2408
Mailing Address - Country:US
Mailing Address - Phone:305-652-2799
Mailing Address - Fax:786-288-5824
Practice Address - Street 1:17011 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2408
Practice Address - Country:US
Practice Address - Phone:305-652-2799
Practice Address - Fax:786-288-5824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21087095251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651275500Medicaid
FL651275500Medicaid