MEDICARE: ATLANTIC CARE HOME HEALTH TALLAHASSEE 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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1467304527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC CARE HOME HEALTH TALLAHASSEE LLC

Provider Business Mailing Address
First Line	:	2802 ALOMA AVE STE 201
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-3532
Country	:	US
Telephone Number	:	407-270-5501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 THOMASVILLE RD STE 326
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5792
Country	:	US
Telephone Number	:	407-270-5501
Fax Number	:

Authorized Official
Title or Position	:	NEW MARKETS
Name	:	MARK GARDNER
Credential	:
Telephone Number	:	602-935-5867

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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