Provider Demographics
NPI:1932535622
Name:HOME HEALTH OF SW FLORIDA, LLC
Entity Type:Organization
Organization Name:HOME HEALTH OF SW FLORIDA, LLC
Other - Org Name:VISITING ANGELS OF SW FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-989-5278
Mailing Address - Street 1:11924 FAIRWAY LAKES DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8434
Mailing Address - Country:US
Mailing Address - Phone:239-561-7600
Mailing Address - Fax:239-561-1698
Practice Address - Street 1:11924 FAIRWAY LAKES DR
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8337
Practice Address - Country:US
Practice Address - Phone:239-561-7600
Practice Address - Fax:239-561-1698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNR 30211639253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care