Healthcare Provider Details

I. General information

NPI: 1134045537
Provider Name (Legal Business Name): GRACE CARE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 WOODLAKE BLVD STE 207-1
GREENACRES FL
33463-3044
US

IV. Provider business mailing address

3900 WOODLAKE BLVD STE 207-1
GREENACRES FL
33463-3044
US

V. Phone/Fax

Practice location:
  • Phone: 561-408-3435
  • Fax: 561-408-3774
Mailing address:
  • Phone: 561-408-3435
  • Fax: 561-408-3774

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: GERALDINE MARQUEZ CUESTA
Title or Position: OWNER
Credential:
Phone: 561-704-1413