MEDICARE: KYNDER HOME HEALTH AGENCY

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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518598168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYNDER HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	3920 VIA DEL REY STE 4
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7594
Country	:	US
Telephone Number	:	239-676-0587
Fax Number	:	239-676-0595

Provider Business Practice Location Address
First Line	:	3920 VIA DEL REY STE 4
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7594
Country	:	US
Telephone Number	:	239-676-0587
Fax Number	:	239-676-0595

Authorized Official
Title or Position	:	OWNER
Name	:	MATEO MARTINEZ
Credential	:
Telephone Number	:	954-993-6299

Provider Enumeration Date	:	02/03/2020
Last Update Date	:	12/30/2021

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Directions to “KYNDER HOME HEALTH AGENCY ” Practice Location

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