Provider Demographics
NPI:1497407464
Name:GUDES, TKELA
Entity Type:Individual
Prefix:
First Name:TKELA
Middle Name:
Last Name:GUDES
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 1:1788 LAKEVIEW VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2029
Mailing Address - Country:US
Mailing Address - Phone:813-841-7240
Mailing Address - Fax:
Practice Address - Street 1:1788 LAKEVIEW VILLAGE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2029
Practice Address - Country:US
Practice Address - Phone:813-841-7240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide