Provider Demographics
NPI:1235582024
Name:ADKINS, JAMES B JR (PRESIDENT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:B
Last Name:ADKINS
Suffix:JR
Gender:M
Credentials:PRESIDENT
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:M
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ADMINISTRATOR
Mailing Address - Street 1:2489 LADOGA DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-9540
Mailing Address - Country:US
Mailing Address - Phone:863-816-5664
Mailing Address - Fax:
Practice Address - Street 1:2489 LADOGA DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-9540
Practice Address - Country:US
Practice Address - Phone:863-816-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL372600000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker