Provider Demographics
NPI:1912904566
Name:HOSPICE OF THE FLORIDA KEYS INC
Entity Type:Organization
Organization Name:HOSPICE OF THE FLORIDA KEYS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-378-2121
Mailing Address - Street 1:1319 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4736
Mailing Address - Country:US
Mailing Address - Phone:305-294-8812
Mailing Address - Fax:305-294-9348
Practice Address - Street 1:1319 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4736
Practice Address - Country:US
Practice Address - Phone:305-294-8812
Practice Address - Fax:305-294-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL50310951251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08752520Medicaid
FL08752520Medicaid