Provider Demographics
NPI:1770184293
Name:DEBSHEBA EMPIRE INC
Entity Type:Organization
Organization Name:DEBSHEBA EMPIRE INC
Other - Org Name:99 CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APRN
Authorized Official - Phone:754-444-0054
Mailing Address - Street 1:4534 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5740
Mailing Address - Country:US
Mailing Address - Phone:754-444-0054
Mailing Address - Fax:954-000-0000
Practice Address - Street 1:4534 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5740
Practice Address - Country:US
Practice Address - Phone:754-444-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty