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General NPI Number Information
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NPI Number | 1164432092
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Entity Type | Organization
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Legal Business Name | MEDI HOME HEALTH
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 2472 CONGRESS ST
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City | FORT MYERS
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State | FL
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Zip | 33901-4909
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Country | US
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Telephone | 239-693-7898
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Fax | 239-693-2237
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Provider Business Mailing Address
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Address Line | 2472 CONGRESS ST
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City | FORT MYERS
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State | FL
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Zip | 33901-4909
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Country | US
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Telephone | 239-693-7898
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Fax | 239-693-2237
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHELLE GUZINSKI
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Credential |
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Telephone | 239-693-7898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA20509095
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License Number State | FL
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