Provider Demographics
NPI:1114630324
Name:AFFINITY CARE OF MANATEE COUNTY LLC
Entity Type:Organization
Organization Name:AFFINITY CARE OF MANATEE COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-499-9977
Mailing Address - Street 1:209 6TH AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1904
Mailing Address - Country:US
Mailing Address - Phone:941-277-5990
Mailing Address - Fax:941-761-5974
Practice Address - Street 1:209 6TH AVE E STE A
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1904
Practice Address - Country:US
Practice Address - Phone:941-277-5990
Practice Address - Fax:941-761-5974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based