Provider Demographics
NPI:1609924265
Name:FLORIDA HOMECARE SPECIALISTS INCORPORATED
Entity Type:Organization
Organization Name:FLORIDA HOMECARE SPECIALISTS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ARCENAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-753-2206
Mailing Address - Street 1:130 N OLD DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-4347
Mailing Address - Country:US
Mailing Address - Phone:352-753-2206
Mailing Address - Fax:352-350-2207
Practice Address - Street 1:130 N OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-4347
Practice Address - Country:US
Practice Address - Phone:352-753-2206
Practice Address - Fax:352-350-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109071Medicare PIN