Healthcare Provider Details

I. General information

NPI: 1447873641
Provider Name (Legal Business Name): NEO HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 CROTON RD
MELBOURNE FL
32935-3161
US

IV. Provider business mailing address

7000 W PALMETTO PARK RD STE 210
BOCA RATON FL
33433-3430
US

V. Phone/Fax

Practice location:
  • Phone: 407-590-4976
  • Fax: 407-707-8635
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA MARIE MARTINOLICH
Title or Position: MANAGER
Credential: RN
Phone: 407-815-4049