Provider Demographics
NPI:1386188209
Name:NURSE CARE REGISTRY
Entity Type:Organization
Organization Name:NURSE CARE REGISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DANYLUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-701-5225
Mailing Address - Street 1:837 NE 20TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-3035
Mailing Address - Country:US
Mailing Address - Phone:754-701-5225
Mailing Address - Fax:754-701-5231
Practice Address - Street 1:837 NE 20TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3035
Practice Address - Country:US
Practice Address - Phone:754-701-5225
Practice Address - Fax:754-701-5231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIN PROCESS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health