Healthcare Provider Details

I. General information

NPI: 1124261284
Provider Name (Legal Business Name): AMBASSADOR HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2009
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 SW 148TH AVE STE 110
MIRAMAR FL
33027-3237
US

IV. Provider business mailing address

3333 S CONGRESS AVE STE 100
DELRAY BEACH FL
33445-7300
US

V. Phone/Fax

Practice location:
  • Phone: 954-733-3330
  • Fax: 561-450-1450
Mailing address:
  • Phone: 561-274-4149
  • Fax: 561-450-1438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299993575
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MICHELLE HUNTER
Title or Position: DIRECTOR OF CONTRACT DEVELOPMENT
Credential:
Phone: 727-888-2844