Provider Demographics
NPI:1336718196
Name:HARVEY, HILDA LOUISE (CNA)
Entity Type:Individual
Prefix:MS
First Name:HILDA
Middle Name:LOUISE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W CYPRESS CREEK RD STE 400H
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1951
Mailing Address - Country:US
Mailing Address - Phone:954-765-6534
Mailing Address - Fax:954-477-8376
Practice Address - Street 1:1001 W CYPRESS CREEK RD STE 400H
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1951
Practice Address - Country:US
Practice Address - Phone:954-765-6534
Practice Address - Fax:954-477-8376
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211514253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care