Healthcare Provider Details

I. General information

NPI: 1619110640
Provider Name (Legal Business Name): LIFEFORCE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 SW 42ND ST
OCALA FL
34471-1364
US

IV. Provider business mailing address

PO BOX 773176
OCALA FL
34477-3176
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-3800
  • Fax: 352-873-4800
Mailing address:
  • Phone: 352-873-3800
  • Fax: 352-873-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 3064662
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 3064782
License Number StateFL

VIII. Authorized Official

Name: JENNIFER ZYLIS
Title or Position: OWNER
Credential: APRN
Phone: 352-873-3800