Provider Demographics
NPI:1235222183
Name:VISITING CARE OF SOUTHWEST FLORIDA, INC.
Entity Type:Organization
Organization Name:VISITING CARE OF SOUTHWEST FLORIDA, INC.
Other - Org Name:A VISITING REDI-NURSE OF SOUTHWEST FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ALTON
Authorized Official - Last Name:HEALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-8800
Mailing Address - Street 1:1800 FOREST HILL BLVD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6094
Mailing Address - Country:US
Mailing Address - Phone:561-433-8800
Mailing Address - Fax:561-641-1168
Practice Address - Street 1:1250 TAMIAMI TRL N
Practice Address - Street 2:SUITE 305
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5248
Practice Address - Country:US
Practice Address - Phone:239-252-5005
Practice Address - Fax:239-252-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108318Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER