Healthcare Provider Details

I. General information

NPI: 1770428963
Provider Name (Legal Business Name): ATHOME LIFE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 N ATLANTIC AVE STE 220
COCOA BEACH FL
32931-3282
US

IV. Provider business mailing address

1980 N ATLANTIC AVE STE 220
COCOA BEACH FL
32931-3282
US

V. Phone/Fax

Practice location:
  • Phone: 888-370-2846
  • Fax:
Mailing address:
  • Phone: 888-370-2846
  • 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: GEORGE THOMAS MYLONAKIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 617-669-3243