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NPI Code Detail

MEDICARE: HEAVENLY HEARTS SERVICES LLC

MEDICARE: HEAVENLY HEARTS 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
1253Z00000XIn Home Supportive Care Agency232623FL

General Provider Information

NPI Number : 1487023602
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEAVENLY HEARTS SERVICES LLC
Provider Business Mailing Address
First Line : 2565 N TOLEDO BLADE BLVD
Second Line : UNIT 1
City : NORTH PORT
State : FL
Zip : 34289-9306
Country : US
Telephone Number : 941-525-8945
Fax Number :
Provider Business Practice Location Address
First Line : 2565 N TOLEDO BLADE BLVD
Second Line : UNIT 1
City : NORTH PORT
State : FL
Zip : 34289-9306
Country : US
Telephone Number : 941-525-8945
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. JANETH RODRIGUEZ
Credential :
Telephone Number : 941-525-8945
Provider Enumeration Date : 09/17/2015
Last Update Date : 09/17/2015

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Directions to “HEAVENLY HEARTS SERVICES LLC ” Practice Location

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