MEDICARE: AFFINITY HOME HEALTHCARE, 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	299994932	OTHER	FL	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265017693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY HOME HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1116
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33443-1116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2328 10TH AVE N STE 600
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6615
Country	:	US
Telephone Number	:	561-483-4044
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	RANON ALTMAN
Credential	:
Telephone Number	:	954-782-3741

Provider Enumeration Date	:	03/17/2021
Last Update Date	:	03/17/2021

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