MEDICARE: EXCEPTIONAL HOME CARE OF FLORIDA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386412773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEPTIONAL HOME CARE OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	2475 MERCER AVE STE 302
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7452
Country	:	US
Telephone Number	:	561-310-5055
Fax Number	:	561-516-7343

Provider Business Practice Location Address
First Line	:	2475 MERCER AVE STE 302
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7452
Country	:	US
Telephone Number	:	561-310-5055
Fax Number	:	561-516-7343

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AUDRA ROUNDTREE
Credential	:
Telephone Number	:	561-310-5055

Provider Enumeration Date	:	12/14/2023
Last Update Date	:	12/14/2023

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