Healthcare Provider Details

I. General information

NPI: 1821842675
Provider Name (Legal Business Name): SWFL PRIMECARE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 SW 20TH AVE
CAPE CORAL FL
33991-3514
US

IV. Provider business mailing address

2105 SW 20TH AVE
CAPE CORAL FL
33991-3514
US

V. Phone/Fax

Practice location:
  • Phone: 239-789-0041
  • Fax:
Mailing address:
  • Phone: 239-789-0041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ARIANNA DANTA
Title or Position: OWNER
Credential:
Phone: 239-789-0041