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Hereward Pennycooke
Attendant Care Provider in Lauderdale Lakes, Florida
NPI 1053072421

Hereward Pennycooke is an Attendant Care Provider based in Lauderdale Lakes, FL and is specialized in Attendant Care Provider. Hereward Pennycooke practices in Lauderdale Lakes, FL. The NPI Number for Hereward Pennycooke is 1053072421 and holds a License No. 11754900 (Florida).

The current practice location address for Hereward Pennycooke is 3489 Nw 24Th St, Lauderdale Lakes, FL and can be reached out via phone at 954-822-3092.

Location: 3489 Nw 24Th St, Lauderdale Lakes, FL, 33311-2610
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053072421
Provider Name
Hereward Pennycooke
Credential
Provider Entity Type
Individual
Gender
Male
Address
3489 Nw 24Th St, Lauderdale Lakes, FL, 33311-2610
Phone Number
954-822-3092
Fax Number
Provider Enumeration Date
01/06/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3747A0650X 05 FL
institution
Provider Business Practice Location Address Details
Address
3489 Nw 24Th St
City
Lauderdale Lakes
State
Florida
Zip
33311-2610
Phone Number
954-822-3092
Fax Number
person
Provider Business Mailing Address Details
Address
3489 Nw 24Th St
City
Lauderdale Lakes
State
Florida
Zip
33311-2610
Phone Number
954-822-3092
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Related Providers
Classification
Technician
Speciality
Attendant Care Provider
Taxonomy
3747A0650X
License No.
11754900 (Florida)
Definition
An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.
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