NPIMap

Organization Active NPI

Kenduck Izquierdo Support Services, Inc

  • Developmentally Disabled Services Day Training Agency
  • Dunnellon, FL
National Provider Identifier
1790089712
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
KENDUCK IZQUIERDO SUPPORT SERVICES, INC
Practice address
7860 SW 204TH Ave
Dunnellon, FL 34431-5169
Phone
(352) 362-8074
Fax
(352) 465-3243
NPI assigned
Jan 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Brenda M KenduckNPI 1295039212
Title
Co Owner/President
Phone
(352) 362-8074

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

7860 SW 204TH Ave
Dunnellon, FL 34431-5169

Mailing address

7860 SW 204TH Ave
Dunnellon, FL 34431-5169
Phone (352) 362-8074

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1790089712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7860 SW 204TH AVE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344315169",
            "telephone_number": "352-362-8074",
            "fax_number": "352-465-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7860 SW 204TH AVE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344315169",
            "telephone_number": "352-362-8074",
            "fax_number": "352-465-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENDUCK IZQUIERDO SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "KENDUCK",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO OWNER/PRESIDENT",
        "authorized_official_telephone_number": "352-362-8074",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunnellon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.