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General NPI Number Information
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NPI Number | 1932861697
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Entity Type | Organization
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Legal Business Name | EXCELLENCE HOME CARE NURSE REGISTRY, LLC.
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 12995 S CLEVELAND AVE STE 52
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City | FORT MYERS
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State | FL
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Zip | 33907-7752
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Country | US
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Telephone | 239-710-0150
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Fax | 239-790-1328
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Provider Business Mailing Address
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Address Line | 12995 S CLEVELAND AVE STE 52
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City | FORT MYERS
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State | FL
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Zip | 33907-7752
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Country | US
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Telephone | 239-710-0150
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Fax | 239-790-1328
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Authorized Official
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Title or Position | PRESIDENT
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Name | LIVIAM MATURELL
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Credential |
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Telephone | 239-710-0150
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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 |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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