Provider Demographics
NPI:1972294759
Name:FUNGWE, FLORENCE P
Entity Type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:P
Last Name:FUNGWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 KING CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5757
Mailing Address - Country:US
Mailing Address - Phone:703-589-0760
Mailing Address - Fax:
Practice Address - Street 1:5680 KING CENTRE DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5757
Practice Address - Country:US
Practice Address - Phone:703-589-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care