Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Demetrius Antwan Haynes

Individual provider Assisted Living Facility · NPI 1619844800

Demetrius Antwan Haynes is an Assisted Living Facility in Lakeland, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2025

Practice location Address checks out

203 Tarawa St
Lakeland, FL 33805-2950
Phone: (646) 717-7222
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X (FL)

Record details

NPI number1619844800
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 21, 2025
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025
Mailing address203 Tarawa St, Lakeland, FL 33805-2950

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