Provider Demographics
NPI:1710504584
Name:BYRD-SAUNDERS, LERONDA (ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:LERONDA
Middle Name:
Last Name:BYRD-SAUNDERS
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 W. 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-5420
Mailing Address - Country:US
Mailing Address - Phone:904-422-3023
Mailing Address - Fax:
Practice Address - Street 1:1712 W. 10TH STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-5420
Practice Address - Country:US
Practice Address - Phone:904-422-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker