Provider Demographics
NPI:1295299014
Name:PROFESSIONAL SENIOR ADVOCATES OF FLORIDA, INC.
Entity type:Organization
Organization Name:PROFESSIONAL SENIOR ADVOCATES OF FLORIDA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:MIKAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO PRESIDENT
Authorized Official - Phone:904-501-5988
Mailing Address - Street 1:101 SE 2ND PL STE 201M
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6413
Mailing Address - Country:US
Mailing Address - Phone:904-501-5988
Mailing Address - Fax:
Practice Address - Street 1:101 SE 2ND PL STE 201M
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6413
Practice Address - Country:US
Practice Address - Phone:904-501-5988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1922437433Medicaid