Brock, Sandra Allene

Brock, Sandra Allene is an sole proprietor health care provider with primary practice located at 101 Twilight St Ne , Palm Bay FL 32907-1151. She recently has only one registered license in Nursing Service Related Providers / Home Health Aide, which is considered as her primary health care specialty. Brock, Sandra Allene can be contacted via phone (321) 984-0430.

Contact Information

Primary practice address
101 Twilight St Ne Palm Bay FL 32907-1151
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Home Health Aide 374U00000X

Profile Details

NPI number 1134381601
LBN Legal business name Brock, Sandra Allene
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2008
Last updated Jun 26th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134381601 NPPES
Florida Other 230526700 FLORIDA MEDICAID PROVIDER NUMBER

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