Provider Demographics
NPI:1821487737
Name:G & J ULTIMATE CARE NURSING SERVICES, LLC.
Entity Type:Organization
Organization Name:G & J ULTIMATE CARE NURSING SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GUERDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALERE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:305-454-0373
Mailing Address - Street 1:800 NE 199TH ST APT 101D
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3013
Mailing Address - Country:US
Mailing Address - Phone:305-454-0373
Mailing Address - Fax:206-278-7124
Practice Address - Street 1:99 NW 183RD ST STE 242A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4502
Practice Address - Country:US
Practice Address - Phone:305-454-0373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211758251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health