Provider Demographics
NPI:1679988158
Name:LUNDY, FRANCHESTER
Entity Type:Individual
Prefix:
First Name:FRANCHESTER
Middle Name:
Last Name:LUNDY
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 1:2004 SW 69TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-3784
Mailing Address - Country:US
Mailing Address - Phone:352-283-3795
Mailing Address - Fax:352-281-4163
Practice Address - Street 1:1722 SW 69TH TER APT B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-3715
Practice Address - Country:US
Practice Address - Phone:352-339-8305
Practice Address - Fax:386-462-4269
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2016-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233639253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013612900Medicaid