Healthcare Provider Details

I. General information

NPI: 1750981239
Provider Name (Legal Business Name): 247 HEALTHCARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 S US HIGHWAY 17/92 STE 106
CASSELBERRY FL
32707-3863
US

IV. Provider business mailing address

5050 S US HIGHWAY 17/92 STE 106
CASSELBERRY FL
32707-3863
US

V. Phone/Fax

Practice location:
  • Phone: 321-800-4488
  • Fax: 321-800-4499
Mailing address:
  • Phone: 321-800-4488
  • Fax: 321-800-4499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DOMINIQUE MATHURIN
Title or Position: VP
Credential:
Phone: 407-779-1613