Provider Demographics
NPI:1285280636
Name:SNEH, LOMAX KONMENA
Entity type:Individual
Prefix:
First Name:LOMAX
Middle Name:KONMENA
Last Name:SNEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 103RD ST APT A2
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-6601
Mailing Address - Country:US
Mailing Address - Phone:202-427-3481
Mailing Address - Fax:
Practice Address - Street 1:8050 103RD ST APT A2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-6601
Practice Address - Country:US
Practice Address - Phone:202-427-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376K00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL833756744Medicaid
FL83-3756744Medicaid