Provider Demographics
NPI:1245272038
Name:ABLE PALMS HOME & HEALTH CARE SERVICES, INC.
Entity type:Organization
Organization Name:ABLE PALMS HOME & HEALTH CARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARTINOLICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-252-2470
Mailing Address - Street 1:3313 W COMMERCIAL BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3413
Mailing Address - Country:US
Mailing Address - Phone:727-586-2711
Mailing Address - Fax:727-674-1192
Practice Address - Street 1:300 LAKE AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-6605
Practice Address - Country:US
Practice Address - Phone:727-586-2711
Practice Address - Fax:727-586-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20073096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109565Medicare Oscar/Certification