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General NPI Number Information
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NPI Number | 1831520394
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Entity Type | Organization
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Legal Business Name | SUNSHINE HEART HOMECARE LLC
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 9378 ARLINGTON EXPRESSWAY 218
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7416
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Country | US
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Telephone | 904-422-6647
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Fax |
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Provider Business Mailing Address
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Address Line | 9378 ARLINGTON EXPY 218
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City | JACKSONVILLE
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State | FL
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Zip | 32225-8213
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Country | US
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Telephone | 904-422-6647
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Fax |
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Authorized Official
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Title or Position | MANGER/OWNER
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Name | JUDITH MCLEOD
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Credential |
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Telephone | 904-422-6647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 233389
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License Number State | FL
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