MEDICARE: ABOVE THE REST

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	230440	FL

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	:	1821411703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE THE REST

Provider Business Mailing Address
First Line	:	9030 NE JACKSONVILLE RD
Second Line	:
City	:	ANTHONY
State	:	FL
Zip	:	32617-3502
Country	:	US
Telephone Number	:	352-622-7038
Fax Number	:	352-236-7039

Provider Business Practice Location Address
First Line	:	9030 NE JACKSONVILLE RD
Second Line	:
City	:	ANTHONY
State	:	FL
Zip	:	32617-3502
Country	:	US
Telephone Number	:	352-622-7038
Fax Number	:	352-236-7039

Authorized Official
Title or Position	:	OWNER
Name	:	JACKIE M THERRIEN
Credential	:
Telephone Number	:	352-622-7038

Provider Enumeration Date	:	01/28/2014
Last Update Date	:	01/28/2014

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Directions to “ABOVE THE REST ” Practice Location

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