Provider Demographics
NPI:1689063596
Name:ON TIME HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:ON TIME HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE NOBREGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-674-9015
Mailing Address - Street 1:3507 LEE BLVD
Mailing Address - Street 2:STE 276
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1318
Mailing Address - Country:US
Mailing Address - Phone:239-674-9015
Mailing Address - Fax:239-674-7944
Practice Address - Street 1:3507 LEE BLVD
Practice Address - Street 2:STE 276
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1318
Practice Address - Country:US
Practice Address - Phone:239-674-9015
Practice Address - Fax:239-674-7944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994330251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health