Provider Demographics
NPI:1629725353
Name:HOMEBOUND PATIENT MEDICAL PROVIDER
Entity Type:Organization
Organization Name:HOMEBOUND PATIENT MEDICAL PROVIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALCIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:954-687-9410
Mailing Address - Street 1:4706 NW 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4734
Mailing Address - Country:US
Mailing Address - Phone:954-687-9410
Mailing Address - Fax:954-678-2608
Practice Address - Street 1:4706 NW 99TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-4734
Practice Address - Country:US
Practice Address - Phone:954-687-9410
Practice Address - Fax:954-678-2608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty