Provider Demographics
NPI:1437380623
Name:DENICA, BILLY
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:DENICA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBYLL
Other - Middle Name:REHABILITATION
Other - Last Name:CARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2610 NW 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-7502
Mailing Address - Country:US
Mailing Address - Phone:305-637-5427
Mailing Address - Fax:
Practice Address - Street 1:2610 NW 19TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-7502
Practice Address - Country:US
Practice Address - Phone:305-637-5427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9437310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility