Provider Demographics
NPI:1619318375
Name:PRIVATE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:PRIVATE ENTERPRISES, INC.
Other - Org Name:PROFESSIONAL NURSES REGISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-549-0022
Mailing Address - Street 1:885 SE 47TH TER STE C
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9079
Mailing Address - Country:US
Mailing Address - Phone:239-549-0022
Mailing Address - Fax:239-549-1739
Practice Address - Street 1:885 SE 47TH TER STE C
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9079
Practice Address - Country:US
Practice Address - Phone:239-549-0022
Practice Address - Fax:239-549-1739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3009096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health