Provider Demographics
NPI:1033503909
Name:SUMMERWOOD HOME HEALTH SERVICES OF DISTRICT 3, LLC
Entity Type:Organization
Organization Name:SUMMERWOOD HOME HEALTH SERVICES OF DISTRICT 3, LLC
Other - Org Name:PALM GARDEN HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-952-9411
Mailing Address - Street 1:2033 MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-6056
Mailing Address - Country:US
Mailing Address - Phone:941-952-9411
Mailing Address - Fax:941-952-9331
Practice Address - Street 1:3200 SW 34TH AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7456
Practice Address - Country:US
Practice Address - Phone:352-877-4120
Practice Address - Fax:352-304-6929
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMERWOOD HEALTHCARE HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-27
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993324251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1094444Medicare PIN
FL1094444Medicare PIN