Healthcare Provider Details

I. General information

NPI: 1649906967
Provider Name (Legal Business Name): ATLANTIC CARE HOME HEALTH CLERMONT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13900 TECH CITY CIR STE 400
ALACHUA FL
32615-6091
US

IV. Provider business mailing address

2802 ALOMA AVE STE 201
WINTER PARK FL
32792-3532
US

V. Phone/Fax

Practice location:
  • Phone: 407-270-5501
  • Fax: 407-559-8971
Mailing address:
  • Phone: 407-270-5501
  • Fax: 407-559-8971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: MARK GARDNER
Title or Position: VP OF NEW MARKETS
Credential:
Phone: 407-270-5501