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NPI Code Detail

MEDICARE: REVOLUTIONARY HOME HEALTH

MEDICARE: REVOLUTIONARY HOME HEALTH
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
1251E00000XHome Health Agency299992118FL

General Provider Information

NPI Number : 1417041534
Entity Type Code : Organization
Provider Name (Legal Business Name) : REVOLUTIONARY HOME HEALTH
Provider Business Mailing Address
First Line : 219 SE 23RD AVE
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-7619
Country : US
Telephone Number : 561-296-2770
Fax Number : 561-296-2771
Provider Business Practice Location Address
First Line : 219 SE 23RD AVE
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33435-7619
Country : US
Telephone Number : 561-296-2770
Fax Number : 561-296-2771
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. DEBRA LEE II
Credential : R.N.
Telephone Number : 561-296-2770
Provider Enumeration Date : 10/03/2006
Last Update Date : 12/02/2025

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Directions to “REVOLUTIONARY HOME HEALTH ” Practice Location

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