Provider Demographics
NPI:1538768171
Name:AMUN- RA HEALTH SERVICES
Entity type:Organization
Organization Name:AMUN- RA HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUHART
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:813-679-8710
Mailing Address - Street 1:5804 BOYETTE RD UNIT 7072
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-8003
Mailing Address - Country:US
Mailing Address - Phone:813-679-8710
Mailing Address - Fax:
Practice Address - Street 1:6446 TABOGI TRL
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-1360
Practice Address - Country:US
Practice Address - Phone:813-679-8710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities