Provider Demographics
NPI:1619013661
Name:DEVINE HOMECARE SERVICES
Entity Type:Organization
Organization Name:DEVINE HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:407-892-9194
Mailing Address - Street 1:2086 CAMELOT BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7001
Mailing Address - Country:US
Mailing Address - Phone:407-892-9194
Mailing Address - Fax:407-892-9194
Practice Address - Street 1:2086 CAMELOT BLVD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-7001
Practice Address - Country:US
Practice Address - Phone:407-892-9194
Practice Address - Fax:407-892-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG06216900262251E00000X
FLPN1298251251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health