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General NPI Number Information
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NPI Number | 1649630518
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Entity Type | Organization
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Legal Business Name | INDEPENDENCE FOR FLORIDA HOME HEALTH. LLC
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 5719 RIORDAN WAY
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City | ORLANDO
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State | FL
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Zip | 32808-2433
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Country | US
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Telephone | 407-757-5455
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Fax | 321-800-6803
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Provider Business Mailing Address
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Address Line | PO BOX 682474
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City | ORLANDO
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State | FL
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Zip | 32868-2474
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Country | US
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Telephone | 407-757-5455
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Fax | 321-800-6803
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | TANYA BLAKE
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Credential |
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Telephone | 407-844-1782
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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 | CNA283280
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License Number State | FL
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