Healthcare Provider Details

I. General information

NPI: 1114839891
Provider Name (Legal Business Name): HAPPY FEET COMPANIONSHIP & PERSONAL SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1548 EMERSON DR SE
PALM BAY FL
32909-3771
US

IV. Provider business mailing address

2328 JAMAICA AVE SW
PALM BAY FL
32908-4526
US

V. Phone/Fax

Practice location:
  • Phone: 305-988-8135
  • Fax:
Mailing address:
  • Phone: 305-988-8135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH COHEN
Title or Position: OWNER
Credential:
Phone: 305-988-8135