Provider Demographics
NPI:1427772110
Name:DYNAMIKS HOME CARE INC WEST
Entity type:Organization
Organization Name:DYNAMIKS HOME CARE INC WEST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FELVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-632-0926
Mailing Address - Street 1:4501 N WICKHAM RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-7180
Mailing Address - Country:US
Mailing Address - Phone:561-632-0926
Mailing Address - Fax:888-429-6515
Practice Address - Street 1:5825 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1216
Practice Address - Country:US
Practice Address - Phone:561-632-0926
Practice Address - Fax:888-429-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health