MEDICARE: MY EXTENDED FAMILY HOME CARE

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	3140N1450X	Pediatric Skilled Nursing Facility

General Provider Information

NPI Number	:	1437776671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY EXTENDED FAMILY HOME CARE

Provider Business Mailing Address
First Line	:	5426 TEXAS AVE
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-7859
Country	:	US
Telephone Number	:	239-784-0132
Fax Number	:

Provider Business Practice Location Address
First Line	:	4766 GOLDEN GATE PKWY STE 4
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34116-6935
Country	:	US
Telephone Number	:	239-285-3990
Fax Number	:	239-449-8469

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	BONIA BAPTISTE
Credential	:
Telephone Number	:	239-784-0132

Provider Enumeration Date	:	07/04/2020
Last Update Date	:	03/10/2022

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Directions to “MY EXTENDED FAMILY HOME CARE ” Practice Location

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