Provider Demographics
NPI:1144987165
Name:TINA SINES
Entity type:Organization
Organization Name:TINA SINES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-598-4551
Mailing Address - Street 1:1214 LABELLE ST APT 159
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-6975
Mailing Address - Country:US
Mailing Address - Phone:904-598-4551
Mailing Address - Fax:904-467-3653
Practice Address - Street 1:1214 LABELLE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6977
Practice Address - Country:US
Practice Address - Phone:904-878-2204
Practice Address - Fax:904-467-3653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108429600Medicaid