Provider Demographics
NPI:1053910430
Name:VOLMY, DIEUNADE
Entity type:Individual
Prefix:
First Name:DIEUNADE
Middle Name:
Last Name:VOLMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 880241
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34988-0241
Mailing Address - Country:US
Mailing Address - Phone:561-541-2300
Mailing Address - Fax:
Practice Address - Street 1:973 NW LEONARDO CIR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4351
Practice Address - Country:US
Practice Address - Phone:561-541-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299995616374U00000X
FL236139376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker