Latanya Earnest

Individual provider Active NPI Skilled Nursing Facility · Heathrow, FL

NPI 1316137599 · NPPES record last updated Jul 25, 2007

Key facts

NPI
1316137599
Entity type
Individual (NPI type 1)
Primary specialty
Skilled Nursing Facility 314000000X
License
03714 (OH)
Practice address
1485 International Pkwy Ste 2051
Heathrow, FL 32746-5352
Phone
(800) 798-6035
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
03714OHMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Voyage Staffing Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 03714 OH Yes

Addresses

Primary practice location

1485 International Pkwy Ste 2051
Heathrow, FL 32746-5352

Mailing address

749 Clinton Ave
Sidney, OH 45365-2111

Other providers in Heathrow, FL

All providers in Heathrow, FL · Skilled Nursing Facility in Florida

Sources for this page

Verify at the official NPI Registry.