Provider Demographics
NPI:1356772982
Name:QUAD NURSE LLC
Entity type:Organization
Organization Name:QUAD NURSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:352-816-7353
Mailing Address - Street 1:2647 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-7048
Mailing Address - Country:US
Mailing Address - Phone:352-484-0296
Mailing Address - Fax:352-577-0554
Practice Address - Street 1:2647 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-7048
Practice Address - Country:US
Practice Address - Phone:352-484-0296
Practice Address - Fax:352-577-0554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-08
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X
FL30211636253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101855700Medicaid
FL009033400Medicaid