Provider Demographics
NPI:1558925727
Name:VALCOURT, GINETTE M
Entity Type:Individual
Prefix:MRS
First Name:GINETTE
Middle Name:M
Last Name:VALCOURT
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 1:3573 OLD BOYNTON RD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-3913
Mailing Address - Country:US
Mailing Address - Phone:561-573-8677
Mailing Address - Fax:561-364-2360
Practice Address - Street 1:3573 OLD BOYNTON RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-3913
Practice Address - Country:US
Practice Address - Phone:561-573-8677
Practice Address - Fax:561-364-2360
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906981372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6906981OtherADULT FAMILY CARE HOME