Provider Demographics
NPI:1235545344
Name:AFTER CARE CENTER OF FLORIDA AT HOLIDAY LLC
Entity Type:Organization
Organization Name:AFTER CARE CENTER OF FLORIDA AT HOLIDAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORGIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-943-0300
Mailing Address - Street 1:1812 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-5535
Mailing Address - Country:US
Mailing Address - Phone:727-943-0300
Mailing Address - Fax:727-943-0339
Practice Address - Street 1:1812 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-5535
Practice Address - Country:US
Practice Address - Phone:727-943-0300
Practice Address - Fax:727-943-0339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7280111N00000X
FLPA9101542363AM0700X
FLARNP9196368363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty