Your Medwaiver Provider INC

NPI #1497055487 in Newberry, Florida

Provider Information

NPI Number
1497055487
Entity Type
Organization
Organization Name
Your Medwaiver Provider INC
Primary Specialty
In Home Supportive Care
Enumeration Date
Oct 25, 2010
Last Updated
Oct 25, 2010

Practice Location

Address
13200 W NEWBERRY RD
Address 2
J50
State
Florida
ZIP Code
32669-2764
Phone
(352) 474-8492

Authorized Official

Name
ANATOLY N LUKYANOV
Title
CEO
Phone
(352) 474-8492

Specialties & Taxonomy Codes

Specialty
Case Management
In Home Supportive Care

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