Provider Demographics
NPI:1710621370
Name:REDDICK, ZAHRELL (HHA, CNA)
Entity Type:Individual
Prefix:
First Name:ZAHRELL
Middle Name:
Last Name:REDDICK
Suffix:
Gender:M
Credentials:HHA, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6304 TINLEY TER
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-7161
Mailing Address - Country:US
Mailing Address - Phone:407-712-3391
Mailing Address - Fax:
Practice Address - Street 1:6304 TINLEY TER
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-7161
Practice Address - Country:US
Practice Address - Phone:407-712-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care