Healthcare Provider Details

I. General information

NPI: 1396101192
Provider Name (Legal Business Name): AMBASSADOR HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 COLONIAL BLVD STE 17 UNIT 200
FORT MYERS FL
33966-1094
US

IV. Provider business mailing address

3333 S CONGRESS AVE STE 100
DELRAY BEACH FL
33445-7300
US

V. Phone/Fax

Practice location:
  • Phone: 239-596-2746
  • Fax: 855-640-7139
Mailing address:
  • Phone: 561-274-4149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number399993950
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MICHELLE HUNTER
Title or Position: DIRECTOR OF CONTRACT DEVELOPMENT
Credential:
Phone: 727-888-2844