MEDICARE: ATLANTIC CARE HOME HEALTH FT LAUDERDALE 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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1760228845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC CARE HOME HEALTH FT LAUDERDALE LLC

Provider Business Mailing Address
First Line	:	163 E MORSE BLVD STE 210
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-7415
Country	:	US
Telephone Number	:	407-270-5501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 W CYPRESS CREEK RD STE 300
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-1953
Country	:	US
Telephone Number	:	407-270-5501
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASON COONS
Credential	:
Telephone Number	:	407-484-2972

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

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