Healthcare Provider Details

I. General information

NPI: 1316408842
Provider Name (Legal Business Name): AFFINITY HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E SAMPLE RD STE 206
POMPANO BEACH FL
33064-4440
US

IV. Provider business mailing address

PO BOX 1116
DEERFIELD BEACH FL
33443-1116
US

V. Phone/Fax

Practice location:
  • Phone: 877-514-5833
  • Fax: 855-919-6080
Mailing address:
  • Phone: 877-514-5833
  • Fax: 855-919-6080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. RANON ALTMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 877-514-5833