Healthcare Provider Details

I. General information

NPI: 1245538719
Provider Name (Legal Business Name): ELDER CARE OF ALACHUA COUNTY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 12/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 NW 34TH BLVD
GAINESVILLE FL
32653-2015
US

IV. Provider business mailing address

5701 NW 34TH BLVD
GAINESVILLE FL
32653-2015
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-9040
  • Fax:
Mailing address:
  • Phone: 352-265-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number5638
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number9149
License Number StateFL

VIII. Authorized Official

Name: MR. ANTHONY MARK CLARIZIO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 352-265-0789