Healthcare Provider Details

I. General information

NPI: 1477469799
Provider Name (Legal Business Name): FULL LIFE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14763 SW 35TH PL
OCALA FL
34481-5286
US

IV. Provider business mailing address

14763 SW 35TH PL
OCALA FL
34481-5286
US

V. Phone/Fax

Practice location:
  • Phone: 786-569-5879
  • Fax:
Mailing address:
  • Phone: 786-569-5879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: YISELYS CONCEPCION PROVEDO
Title or Position: OWNER
Credential:
Phone: 786-569-5870