Provider Demographics
NPI:1346627668
Name:HEALEX HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:HEALEX HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-597-2068
Mailing Address - Street 1:3900 MANNIX DR STE 118
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-5403
Mailing Address - Country:US
Mailing Address - Phone:239-597-2068
Mailing Address - Fax:239-674-3189
Practice Address - Street 1:3900 MANNIX DR STE 118
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-5403
Practice Address - Country:US
Practice Address - Phone:239-597-2068
Practice Address - Fax:239-674-3189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211764251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30211764OtherFL DEPARTMENT OF HEALTH