Provider Demographics
NPI:1467459818
Name:HOSPICE OF THE FLORIDA KEYS INC
Entity Type:Organization
Organization Name:HOSPICE OF THE FLORIDA KEYS INC
Other - Org Name:VISITING NURSE ASSOCIATION OF THE FLORIDA KEYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-271-4642
Mailing Address - Street 1:4200 NW 90TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-3809
Mailing Address - Country:US
Mailing Address - Phone:352-378-2121
Mailing Address - Fax:352-240-1470
Practice Address - Street 1:1319 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4736
Practice Address - Country:US
Practice Address - Phone:305-294-8812
Practice Address - Fax:305-294-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21245096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL027004100Medicaid
107263Medicare UPIN