Healthcare Provider Details

I. General information

NPI: 1588543193
Provider Name (Legal Business Name): GENTLE SPIRITS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N PARK RD STE 503B
HOLLYWOOD FL
33021-6918
US

IV. Provider business mailing address

450 N PARK RD STE 503B
HOLLYWOOD FL
33021-6918
US

V. Phone/Fax

Practice location:
  • Phone: 305-552-2416
  • Fax: 786-765-5858
Mailing address:
  • Phone: 305-552-2416
  • Fax: 786-765-5858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. CEDRICK SPEARS
Title or Position: CEO
Credential: AMBR
Phone: 931-801-1866