MEDICARE: AMERICAN ELDERCARE, 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	HHA299992115	FL

General Provider Information

NPI Number	:	1417918541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN ELDERCARE, INC

Provider Business Mailing Address
First Line	:	3320 NW 53RD ST
Second Line	:	SUITE 203
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6324
Country	:	US
Telephone Number	:	954-734-1476
Fax Number	:	561-495-0519

Provider Business Practice Location Address
First Line	:	3320 NW 53RD ST
Second Line	:	SUITE 203
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6324
Country	:	US
Telephone Number	:	954-734-1476
Fax Number	:	561-495-0519

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. OWEPATRICE GAILLARD
Credential	:	RN
Telephone Number	:	561-558-7008

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	04/20/2016

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