Healthcare Provider Details

I. General information

NPI: 1699608356
Provider Name (Legal Business Name): GENERATIONS & WELLNESS HOMECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3592 BROADWAY STE 130
FORT MYERS FL
33901-8056
US

IV. Provider business mailing address

PO BOX 62643
FORT MYERS FL
33906-2643
US

V. Phone/Fax

Practice location:
  • Phone: 239-896-7809
  • Fax:
Mailing address:
  • Phone: 239-896-7809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LATASHA CARTER
Title or Position: CEO
Credential:
Phone: 239-896-7809