Provider Demographics
NPI:1255954384
Name:FLORIDA ACCESS CARE INC
Entity type:Organization
Organization Name:FLORIDA ACCESS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDZARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-259-4322
Mailing Address - Street 1:4805 VILABELLA DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-2357
Mailing Address - Country:US
Mailing Address - Phone:863-259-4322
Mailing Address - Fax:863-259-4306
Practice Address - Street 1:4805 VILABELLA DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-2357
Practice Address - Country:US
Practice Address - Phone:863-259-4322
Practice Address - Fax:863-259-4306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL13459OtherAHCA