MEDICARE: ACCESS HOME HEALTH 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HC5	OTHER		G2

General Provider Information

NPI Number	:	1831129162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS HOME HEALTH OF FLORIDA, LLC

Provider Business Mailing Address
First Line	:	6330 SPRINT PKWY STE 300
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-1157
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 NW LAKE WHITNEY PL
Second Line	:	SUITE 106
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-1605
Country	:	US
Telephone Number	:	772-223-2116
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED SIGNATORY
Name	:	JOHN NICHOLS
Credential	:
Telephone Number	:	772-223-2116

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	09/05/2022

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