Provider Demographics
NPI:1407594534
Name:DEBS, KENIA
Entity Type:Individual
Prefix:
First Name:KENIA
Middle Name:
Last Name:DEBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W 4TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4782
Mailing Address - Country:US
Mailing Address - Phone:786-253-7657
Mailing Address - Fax:
Practice Address - Street 1:65 W 4TH ST APT 105
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4782
Practice Address - Country:US
Practice Address - Phone:786-253-7657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3814374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide