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General NPI Number Information
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NPI Number | 1265797369
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Entity Type | Organization
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Legal Business Name | AMERICAN ELDERCARE OF NORTH FLORIDA, LLC
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 325 JOHN KNOX ROAD BUILDING F SUITE 240
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City | TALLAHASSEE
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State | FL
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Zip | 32303-4152
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Country | US
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Telephone | 850-462-1380
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Fax | 850-462-1399
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Provider Business Mailing Address
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Address Line | 325 JOHN KNOX ROAD BUILDING F SUITE 240
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City | TALLAHASSEE
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State | FL
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Zip | 32303-4152
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Country | US
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Telephone | 850-462-1380
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Fax | 850-462-1399
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Authorized Official
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Title or Position | RN FLL
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Name | MS. STEPHANIE BROOKE WILLEY
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Credential | RN
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Telephone | 850-486-6093
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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 | 299993955
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License Number State | FL
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