MEDICARE: DISCOVERY AT HOME 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	PENDING	FL

General Provider Information

NPI Number	:	1427352558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISCOVERY AT HOME LLC

Provider Business Mailing Address
First Line	:	4857 PALM BEACH BLVD STE 4
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-3206
Country	:	US
Telephone Number	:	239-676-2080
Fax Number	:	239-676-2089

Provider Business Practice Location Address
First Line	:	4857 PALM BEACH BLVD STE 4
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-3206
Country	:	US
Telephone Number	:	239-676-2080
Fax Number	:	239-676-2089

Authorized Official
Title or Position	:	DIRECTOR OF QUALITY ASSURANCE
Name	:	JENNIFER PETERSEN
Credential	:	RN
Telephone Number	:	801-707-1797

Provider Enumeration Date	:	01/04/2011
Last Update Date	:	09/03/2025

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