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General NPI Number Information
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NPI Number | 1922328848
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Entity Type | Organization
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Legal Business Name | CMK HOME HEALTH OF FLORIDA, LLC
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 116 S TENNESSEE AVE SUITE 216
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City | LAKELAND
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State | FL
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Zip | 33801-4631
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Country | US
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Telephone | 630-765-2392
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Fax |
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Provider Business Mailing Address
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Address Line | 116 S TENNESSEE AVE SUITE 216
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City | LAKELAND
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State | FL
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Zip | 33801-4631
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Country | US
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Telephone | 630-765-2392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL J ECHEVARRIA
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Credential |
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Telephone | 630-765-2392
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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 |
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License Number State | FL
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