Provider Demographics
NPI:1043586316
Name:FLORIDA HOPE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:FLORIDA HOPE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DESIR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:954-788-7555
Mailing Address - Street 1:1200 SW 3RD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3240
Mailing Address - Country:US
Mailing Address - Phone:954-788-7555
Mailing Address - Fax:954-317-5626
Practice Address - Street 1:1200 SW 3RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3240
Practice Address - Country:US
Practice Address - Phone:954-788-7555
Practice Address - Fax:954-317-5626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994052251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009641400Medicaid