Healthcare Provider Details

I. General information

NPI: 1427352558
Provider Name (Legal Business Name): DISCOVERY AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4857 PALM BEACH BLVD STE 4
FORT MYERS FL
33905-3206
US

IV. Provider business mailing address

4857 PALM BEACH BLVD STE 4
FORT MYERS FL
33905-3206
US

V. Phone/Fax

Practice location:
  • Phone: 239-676-2080
  • Fax: 239-676-2089
Mailing address:
  • Phone: 239-676-2080
  • Fax: 239-676-2089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPENDING
License Number StateFL

VIII. Authorized Official

Name: JENNIFER PETERSEN
Title or Position: DIRECTOR OF QUALITY ASSURANCE
Credential: RN
Phone: 801-707-1797