MEDICARE: DOUGLAS HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013966894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	2803 FLIGHT SAFETY DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-7911
Country	:	US
Telephone Number	:	772-770-0022
Fax Number	:	772-770-4434

Provider Business Practice Location Address
First Line	:	2803 FLIGHT SAFETY DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-7911
Country	:	US
Telephone Number	:	772-770-0022
Fax Number	:	772-770-4434

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. ANNE MARIE DOUGLAS
Credential	:	RN
Telephone Number	:	772-770-0022

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/18/2018

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