MEDICARE: PHILADELPHIA HOME HEALTH CARE INC

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	10D2273308	OTHER	FL	CLIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	299995737	OTHER	FL	AHCA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275254088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILADELPHIA HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1650 SAND LAKE RD STE 395
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-9122
Country	:	US
Telephone Number	:	407-201-6078
Fax Number	:	407-201-4979

Provider Business Practice Location Address
First Line	:	1650 SAND LAKE RD STE 395
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-9122
Country	:	US
Telephone Number	:	407-201-6078
Fax Number	:	407-201-4979

Authorized Official
Title or Position	:	CEO
Name	:	FEDERICO NICHOLAS
Credential	:
Telephone Number	:	407-433-5816

Provider Enumeration Date	:	09/09/2022
Last Update Date	:	12/15/2025

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