Provider Demographics
NPI:1225228588
Name:FLORIDA HOME HEALTH SERVICES,LLC
Entity Type:Organization
Organization Name:FLORIDA HOME HEALTH SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-255-8640
Mailing Address - Street 1:205 W WASHINGTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-5580
Mailing Address - Country:US
Mailing Address - Phone:352-255-8640
Mailing Address - Fax:
Practice Address - Street 1:205 W WASHINGTON ST
Practice Address - Street 2:STE B
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-5580
Practice Address - Country:US
Practice Address - Phone:352-255-8640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL07000063969251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health