Provider Demographics
NPI:1861073066
Name:AZARIAH NURSE REGISTRY LLC
Entity type:Organization
Organization Name:AZARIAH NURSE REGISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YURIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTANA FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-526-3851
Mailing Address - Street 1:6611 US HWY 19 S
Mailing Address - Street 2:STE 210
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1732
Mailing Address - Country:US
Mailing Address - Phone:727-835-7207
Mailing Address - Fax:727-478-3071
Practice Address - Street 1:6611 US HWY 19 S
Practice Address - Street 2:STE 210
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1732
Practice Address - Country:US
Practice Address - Phone:727-835-7207
Practice Address - Fax:727-478-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty