Healthcare Provider Details

I. General information

NPI: 1083455034
Provider Name (Legal Business Name): REIDS ELITE KARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 ROBERT J CONLAN BLVD NE APT 101
PALM BAY FL
32905-2765
US

IV. Provider business mailing address

11582 SW VILLAGE PKWY UNIT 146
PORT SAINT LUCIE FL
34987-2392
US

V. Phone/Fax

Practice location:
  • Phone: 772-271-0475
  • Fax:
Mailing address:
  • Phone: 772-271-0475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SIMONE N REID
Title or Position: CNA/HHA
Credential:
Phone: 954-548-0602