Provider Demographics
NPI:1235518416
Name:TUMENTA, JOVIEL
Entity Type:Individual
Prefix:MR
First Name:JOVIEL
Middle Name:
Last Name:TUMENTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 LANCER DR APT 9
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3216
Mailing Address - Country:US
Mailing Address - Phone:240-425-7578
Mailing Address - Fax:
Practice Address - Street 1:3334 LANCER DR APT 9
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3216
Practice Address - Country:US
Practice Address - Phone:240-425-7578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11224374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide