Patrick Cunningham, BUILDING CONTRACTOR

Individual provider Active NPI Home Modifications Contractor · Lake Butler, FL

NPI 1003259136 · NPPES record last updated Apr 8, 2013

Key facts

NPI
1003259136
Entity type
Individual (NPI type 1)
Primary specialty
Home Modifications Contractor 171WH0202X
License
CBC059880 (FL)
Practice address
11595 NE County Road 237
Lake Butler, FL 32054-5235
Phone
(352) 494-2300
NPI assigned
Apr 8, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CBC059880FLMDHome Modifications Contractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X CBC059880 FL Yes

Addresses

Primary practice location

11595 NE County Road 237
Lake Butler, FL 32054-5235

Mailing address

11595 NE County Road 237
Lake Butler, FL 32054-5235
Phone (352) 494-2300

Other identifiers

IdentifierTypeStateIssuer
690070400MedicaidFL

Other providers in Lake Butler, FL

All providers in Lake Butler, FL · Home Modifications Contractor in Florida

Sources for this page

Verify at the official NPI Registry.