Provider Demographics
NPI:1891265666
Name:HENDRICKS, JANET (MFC PARENT PROVIDER)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:MFC PARENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18185 SW 26TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5147
Mailing Address - Country:US
Mailing Address - Phone:954-433-2910
Mailing Address - Fax:954-433-2911
Practice Address - Street 1:18185 SW 26TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5147
Practice Address - Country:US
Practice Address - Phone:954-433-2910
Practice Address - Fax:954-433-2911
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3000567003747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant