Provider Demographics
NPI:1205896255
Name:PRN NURSINGS SERVICES, INC
Entity type:Organization
Organization Name:PRN NURSINGS SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-265-4482
Mailing Address - Street 1:770 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE# 304
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2065
Mailing Address - Country:US
Mailing Address - Phone:305-265-4482
Mailing Address - Fax:305-265-7622
Practice Address - Street 1:770 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE# 304
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2065
Practice Address - Country:US
Practice Address - Phone:305-265-4482
Practice Address - Fax:305-265-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21569096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650557103Medicaid
FL650557101Medicaid
FL60-70175OtherUNITEDHEALTHCARE
FL650557100Medicaid
FL650557196Medicaid
FL10-8465Medicare PIN