Provider Demographics
NPI:1023489036
Name:SDX HOME CARE OPERATIONS, LLC
Entity type:Organization
Organization Name:SDX HOME CARE OPERATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AZANKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-621-9649
Mailing Address - Street 1:1035 NW 57TH STREET
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:352-331-7760
Mailing Address - Fax:352-331-7761
Practice Address - Street 1:1035 NW 57TH STREET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605
Practice Address - Country:US
Practice Address - Phone:352-331-7760
Practice Address - Fax:352-331-7761
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SDX HOME CARE OPERATIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-16
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992787253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care