Healthcare Provider Details

I. General information

NPI: 1760871610
Provider Name (Legal Business Name): SHC HOME HEALTH SERVICES OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2015
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 W STATE ROAD 434 SUITE 6140
LONGWOOD FL
32779-5041
US

IV. Provider business mailing address

12201 BLUEGRASS PKWY
LOUISVILLE KY
40299-2361
US

V. Phone/Fax

Practice location:
  • Phone: 407-834-0020
  • Fax: 407-834-0080
Mailing address:
  • Phone: 502-568-7800
  • Fax: 502-259-0183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOHN HARRISON
Title or Position: CFO
Credential:
Phone: 502-568-7800