Provider Demographics
NPI:1649630518
Name:INDEPENDENCE FOR FLORIDA HOME HEALTH. LLC
Entity type:Organization
Organization Name:INDEPENDENCE FOR FLORIDA HOME HEALTH. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-844-1782
Mailing Address - Street 1:PO BOX 682474
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32868-2474
Mailing Address - Country:US
Mailing Address - Phone:407-757-5455
Mailing Address - Fax:321-800-6803
Practice Address - Street 1:5719 RIORDAN WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-2433
Practice Address - Country:US
Practice Address - Phone:407-757-5455
Practice Address - Fax:321-800-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA283280251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health