MEDICARE: RAPHA HOME 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1407586340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPHA HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	5425 GOLDEN GATE PKWY STE 1E
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34116-7524
Country	:	US
Telephone Number	:	407-692-1322
Fax Number	:

Provider Business Practice Location Address
First Line	:	5425 GOLDEN GATE PKWY STE 1E
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34116-7524
Country	:	US
Telephone Number	:	407-692-1322
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	ELIDIANE DERA
Credential	:
Telephone Number	:	407-692-1322

Provider Enumeration Date	:	06/14/2022
Last Update Date	:	06/14/2022

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Directions to “RAPHA HOME HEALTH SERVICES LLC ” Practice Location

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