Provider Demographics
NPI:1831110709
Name:CARETENDERS VISITING SERVICES OF SOUTHWEST FLORIDA, INC
Entity Type:Organization
Organization Name:CARETENDERS VISITING SERVICES OF SOUTHWEST FLORIDA, INC
Other - Org Name:CARETENDERSR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. V. P., ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-891-1004
Mailing Address - Street 1:9510 ORMSBY STATION RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4081
Mailing Address - Country:US
Mailing Address - Phone:502-891-1000
Mailing Address - Fax:502-891-8067
Practice Address - Street 1:15550 MCGREGOR BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2579
Practice Address - Country:US
Practice Address - Phone:239-481-5999
Practice Address - Fax:239-481-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107406Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER