MEDICARE: PANHEALTH 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

General Provider Information

NPI Number	:	1497456198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PANHEALTH LLC

Provider Business Mailing Address
First Line	:	4780 N HEMINGWAY CIR
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5378
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6750 N ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-2173
Country	:	US
Telephone Number	:	954-226-3199
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JULLET MILLER SIMPSON
Credential	:
Telephone Number	:	954-226-3199

Provider Enumeration Date	:	03/10/2023
Last Update Date	:	03/10/2023

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