MR. RAYMOND B HENDRICKS (NPI# 1144699646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144699646 |
| Entity Type | Individual |
| Full Name | MR. RAYMOND B HENDRICKS |
| Practice Address |
1306 Annette St Port Charlotte FL 33980 |
| Practice Telephone | 9417641572 |
| Mailing Telephone | 9417641572 |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906749 | FL | Nursing & Custodial Care Facilities |
| Street Address |
1306 ANNETTE ST |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33980 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649616517 | Anne Yvonne Clarke | Nurse's Aide | 3378 Idlewild Street, Port Charlotte, FL 33980 | 2013-05-17 |
| 1427395680 | John F Guarino Md Pa | Surgery | 4245 Kings Hwy, Unit A, Port Charlotte, FL 33980 | 2013-01-08 |
| 1497049027 | Patricia Ann Drow | Occupational Therapist | 24469 Manchester Trail, Port Charlotte, FL 33980 | 2011-05-31 |
| 1811221484 | Amanda K Huffman | Clinical Nurse Specialist | 22655 Bayshore Rd Ste 130, Port Charlotte, FL 33980 | 2009-09-29 |
| 1093967739 | Donna Olson | Nurse Practitioner | 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2008-10-14 |
| 1821278029 | Paula Marie Allison | Dietitian, Registered | 23422 Burlingame Ave, Port Charlotte, FL 33980 | 2007-11-06 |
| 1689865891 | Keith Anthony Williams | Physical Medicine & Rehabilitation | 4265 Laura Street, Port Charlotte, FL 33980 | 2007-08-05 |
| 1578685491 | Richard Michael Cocchieri | Dentist | Florida Department of Health In Charlotte County, 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2007-04-03 |
| 1417989328 | John F Guarino | Surgery | 4245 Kings Highway, Unit A, Port Charlotte, FL 33980 | 2006-07-07 |
| 1023086352 | Total Renal Care Inc | Clinic/Center | 4300 Kings Hwy Ste 406, Port Charlotte, FL 33980 | 2006-03-11 |
| Find all providers in zip 33980 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366864795 | Ivy Flo Moore | Custodial Care Facility | 23145 Gray Ave, Port Charlotte, FL 33980-8587 | 2014-01-21 |
| 1922438464 | Julliet Jackson | Custodial Care Facility | 17345 Edgewater Dr, Port Charlotte, FL 33948-2343 | 2013-11-20 |
| 1508203571 | Chery Adult Family Care Home | Custodial Care Facility | 1048 Renoir St, Port Charlotte, FL 33952-1762 | 2013-05-30 |
| 1881031417 | Eddison Nelson | Custodial Care Facility | 1292 Dorchester St, Port Charlotte, FL 33952-2512 | 2013-05-22 |
| 1356788996 | Jeanette Gadsden | Custodial Care Facility | 1113 Fleetwood Dr Nw, Port Charlotte, FL 33948-2001 | 2013-05-22 |
| 1750727061 | Spliddie Harrison | Custodial Care Facility | 23529 Quasar Blvd, Port Charlotte, FL 33980-3120 | 2013-05-14 |
| 1346686714 | George Harris | Custodial Care Facility | 152 Torrington St, Port Charlotte, FL 33954-2424 | 2013-05-13 |
| 1174969588 | Annette Angela Hughes | Custodial Care Facility | 18520 Satsuma Ave, Port Charlotte, FL 33948-7520 | 2013-05-13 |
| 1528404928 | Merona Grey | Custodial Care Facility | 23167 Wilkinson Ave, Port Charlotte, FL 33980-5865 | 2013-05-13 |
| 1538503784 | Sharon Marcia Nelson | Custodial Care Facility | 21459 Seaton Ave, Port Charlotte, FL 33954-3251 | 2013-04-18 |
| Find all providers in PORT CHARLOTTE | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33980 |
Please comment or provide details below to improve the information on MR. RAYMOND B HENDRICKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.