MEDICARE: ETHIC 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1346640992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETHIC HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	13574 VILLAGE PARK DR STE 220
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-7694
Country	:	US
Telephone Number	:	407-530-5915
Fax Number	:	407-530-5916

Provider Business Practice Location Address
First Line	:	13574 VILLAGE PARK DR STE 220
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-7694
Country	:	US
Telephone Number	:	407-530-5915
Fax Number	:	407-530-5916

Authorized Official
Title or Position	:	OWNER
Name	:	SAILY GOMEZ
Credential	:
Telephone Number	:	407-530-5915

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	08/31/2021

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