Healthcare Provider Details

I. General information

NPI: 1700752490
Provider Name (Legal Business Name): HEART N SOUL HOSPICE OF FORT MYERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11934 FAIRWAY LAKES DR STE 3
FORT MYERS FL
33913-8335
US

IV. Provider business mailing address

11934 FAIRWAY LAKES DR STE 3
FORT MYERS FL
33913-8335
US

V. Phone/Fax

Practice location:
  • Phone: 239-507-9030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACY WOOD
Title or Position: COO
Credential:
Phone: 615-835-3822