=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902412794
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENHANCED FLORIDA HOMES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2020
-----------------------------------------------------
Last Update Date | 09/17/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8002 CHERRY LAKE RD
-----------------------------------------------------
City | GROVELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34736-9007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-948-5178
-----------------------------------------------------
Fax | 352-429-2704
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8002 CHERRY LAKE RD
-----------------------------------------------------
City | GROVELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34736-9007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-948-5178
-----------------------------------------------------
Fax | 352-429-2704
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. DANA ZAYNE MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-948-5178
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171WH0202X
-----------------------------------------------------
Taxonomy Name | Home Modifications Contractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------