Healthcare Provider Details

I. General information

NPI: 1477067049
Provider Name (Legal Business Name): BENEVOLENT HEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2017
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10151 DEERWOOD PARK BLVD STE 200-250
JACKSONVILLE FL
32256-0589
US

IV. Provider business mailing address

10151 DEERWOOD PARK BLVD STE 200-250
JACKSONVILLE FL
32256-0589
US

V. Phone/Fax

Practice location:
  • Phone: 904-638-1739
  • Fax: 866-728-4298
Mailing address:
  • Phone: 904-638-1739
  • Fax: 866-728-4298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY WHYTE
Title or Position: ADMINISTRATOR
Credential:
Phone: 904-638-1739