Tmbur Banis, CNA
Individual provider Active NPI Nurse's Aide · Belle Glade, FL
NPI 1104565480 · NPPES record last updated Jun 3, 2022
Key facts
- NPI
- 1104565480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 406126 (FL)
- Practice address
- 4019 NW 17TH St
Belle Glade, FL 33430-5928 - Phone
- (561) 755-2991
- NPI assigned
- Jun 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 406126 | FL | MD | Nurse's Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 406126 | FL | Yes |
Addresses
Primary practice location
4019 NW 17TH St
Belle Glade, FL 33430-5928
Mailing address
4019 NW 17TH St
Belle Glade, FL 33430-5928
Phone (561) 755-2991
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7867879196 | Medicaid | FL |
Other providers in Belle Glade, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.