Healthcare Provider Details

I. General information

NPI: 1114785391
Provider Name (Legal Business Name): HEALING HANDS IV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 SHARON CIR
PORT CHARLOTTE FL
33952-8348
US

IV. Provider business mailing address

690 SHARON CIR
PORT CHARLOTTE FL
33952-8348
US

V. Phone/Fax

Practice location:
  • Phone: 941-276-2552
  • Fax: 941-761-6959
Mailing address:
  • Phone: 941-276-2552
  • Fax: 941-761-6959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCELLO NICOLOSI
Title or Position: OWNER/FOUNDER
Credential: RN
Phone: 941-276-2552