Provider Demographics
NPI:1245670132
Name:SHS SWFL LLC
Entity type:Organization
Organization Name:SHS SWFL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO, CFO, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-243-8555
Mailing Address - Street 1:12995 S CLEVELAND AVE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3890
Mailing Address - Country:US
Mailing Address - Phone:239-243-8555
Mailing Address - Fax:
Practice Address - Street 1:12995 S CLEVELAND AVE
Practice Address - Street 2:SUITE 40
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3890
Practice Address - Country:US
Practice Address - Phone:239-243-8555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL232083253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care