Provider Demographics
NPI:1740603943
Name:INFINITY HEALTHCARE PROVIDERS
Entity Type:Organization
Organization Name:INFINITY HEALTHCARE PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSING ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-412-4750
Mailing Address - Street 1:7608 ARBLE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-3006
Mailing Address - Country:US
Mailing Address - Phone:904-412-4750
Mailing Address - Fax:904-374-3122
Practice Address - Street 1:7608 ARBLE DR
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-3006
Practice Address - Country:US
Practice Address - Phone:904-412-4750
Practice Address - Fax:904-374-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL224706251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health