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General NPI Number Information
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NPI Number | 1205617867
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Entity Type | Organization
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Legal Business Name | FLOS PASSIONATE COMPANY HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 108 E SEMINOLE AVE
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City | LAKE WALES
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State | FL
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Zip | 33853-3627
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Country | US
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Telephone | 863-605-5129
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | LAKE WALES
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State | FL
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Zip | 33859-0130
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Country | US
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Telephone | 860-605-5129
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FLORIA PETERSON
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Credential |
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Telephone | 860-605-5129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number |
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License Number State |
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