Provider Demographics
NPI:1477250074
Name:KEYS ISLAND NURSE CORP
Entity Type:Organization
Organization Name:KEYS ISLAND NURSE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAXI
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:786-647-8736
Mailing Address - Street 1:94825 OVERSEAS HWY UNIT 255
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-3898
Mailing Address - Country:US
Mailing Address - Phone:786-647-8736
Mailing Address - Fax:
Practice Address - Street 1:94825 OVERSEAS HWY UNIT 255
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-3898
Practice Address - Country:US
Practice Address - Phone:786-647-8736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty