Provider Demographics
NPI:1689749442
Name:VANESSA HOWARD
Entity Type:Organization
Organization Name:VANESSA HOWARD
Other - Org Name:VANESSA HOWARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:H&C BASED SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-657-2728
Mailing Address - Street 1:707 PALM RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:IMMOKALEE
Mailing Address - State:FL
Mailing Address - Zip Code:34142
Mailing Address - Country:US
Mailing Address - Phone:239-839-1630
Mailing Address - Fax:239-657-2356
Practice Address - Street 1:707 PALM RIDGE DR
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-4221
Practice Address - Country:US
Practice Address - Phone:239-839-1630
Practice Address - Fax:239-657-2356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL690966396OtherSPECIALIST