Healthcare Provider Details

I. General information

NPI: 1619896958
Provider Name (Legal Business Name): MRC HEALTHCARE L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3049 CLEVELAND AVE STE 105
FORT MYERS FL
33901-7049
US

IV. Provider business mailing address

3049 CLEVELAND AVE STE 105
FORT MYERS FL
33901-7049
US

V. Phone/Fax

Practice location:
  • Phone: 239-789-1829
  • Fax: 239-789-1758
Mailing address:
  • Phone: 239-789-1829
  • Fax: 239-789-1758

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: MARICEL RODRIGUEZ CANIZARES
Title or Position: OWNER / D.O.N.
Credential: RN
Phone: 239-789-1829