Provider Demographics
NPI:1851977987
Name:PS REGISTERED NURSE
Entity Type:Organization
Organization Name:PS REGISTERED NURSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JUANTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHYNES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:407-722-9474
Mailing Address - Street 1:7718 LAKE ANDREA CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-7313
Mailing Address - Country:US
Mailing Address - Phone:407-722-9474
Mailing Address - Fax:407-857-0205
Practice Address - Street 1:6220 S ORANGE BLOSSOM TRL STE 517
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4685
Practice Address - Country:US
Practice Address - Phone:407-722-9474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care