Healthcare Provider Details

I. General information

NPI: 1871951640
Provider Name (Legal Business Name): HOMECARE DIMENSIONS OF FLORIDA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2016
Last Update Date: 02/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 BAYMEADOWS RD STE 12
JACKSONVILLE FL
32256-7435
US

IV. Provider business mailing address

12500 NETWORK BLVD STE 210
SAN ANTONIO TX
78249-3307
US

V. Phone/Fax

Practice location:
  • Phone: 210-696-2626
  • Fax: 210-696-9987
Mailing address:
  • Phone: 210-696-2626
  • Fax: 210-696-9987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN PATRICK OLIVAS
Title or Position: PRESIDENT
Credential:
Phone: 210-696-2626