NPI 1144699646

Raymond B Hendricks

Practitioner Adult Care Home Facility Port Charlotte, FL

Practice location

Address: 1306 Annette St, Port Charlotte, FL 33980
Phone: (941) 764-1572

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 6906749 (FL)

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Registry record

NPI: 1144699646
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Sep 2015
Record last updated: 15 Sep 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.