Provider Demographics
NPI:1942259874
Name:FLORIDA HOSPITAL HOME INFUSION, LLP
Entity Type:Organization
Organization Name:FLORIDA HOSPITAL HOME INFUSION, LLP
Other - Org Name:ADVENTHEALTH HOME INFUSION CENTRAL FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-818-7665
Mailing Address - Street 1:500 WINDERLEY PL STE 228
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7407
Mailing Address - Country:US
Mailing Address - Phone:407-660-1122
Mailing Address - Fax:407-660-0097
Practice Address - Street 1:556 FLORIDA CENTRAL PKWY
Practice Address - Street 2:SUITE 1044
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5174
Practice Address - Country:US
Practice Address - Phone:407-865-5489
Practice Address - Fax:407-865-9679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 12210332BP3500X
FLPH122103336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJQ4OtherBLUE CROSS
FL102135400Medicaid
FL102135400Medicaid