Provider Demographics
NPI:1508314055
Name:ENHANCE HEALTH INC.
Entity Type:Organization
Organization Name:ENHANCE HEALTH INC.
Other - Org Name:ENHANCE DIABETES HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:WAVANEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KETTLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-569-9601
Mailing Address - Street 1:11709 HOLLY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2018
Mailing Address - Country:US
Mailing Address - Phone:813-569-9601
Mailing Address - Fax:813-609-6784
Practice Address - Street 1:11709 HOLLY CREEK DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2018
Practice Address - Country:US
Practice Address - Phone:813-569-9601
Practice Address - Fax:813-609-6784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29361251K00000X
FL21291251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare