Healthcare Provider Details

I. General information

NPI: 1801728290
Provider Name (Legal Business Name): MADDOX LICENSED CARE & PRIVATE DUTY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 NEWBERRY RD STE D8
GAINESVILLE FL
32607-2177
US

IV. Provider business mailing address

5200 NEWBERRY RD STE D8
GAINESVILLE FL
32607-2177
US

V. Phone/Fax

Practice location:
  • Phone: 352-554-6239
  • Fax:
Mailing address:
  • Phone: 352-554-6239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: ANDREW P MADDOX
Title or Position: CEO
Credential:
Phone: 352-213-3307