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NPI Code Detail

MEDICARE: 2ND HOME SKILLED CARE SERVICES FLORIDA LLC

MEDICARE: 2ND HOME SKILLED CARE SERVICES FLORIDA 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1598585614
Entity Type Code : Organization
Provider Name (Legal Business Name) : 2ND HOME SKILLED CARE SERVICES FLORIDA LLC
Provider Business Mailing Address
First Line : 3131 S VAUGHN WAY STE 600
Second Line :
City : AURORA
State : CO
Zip : 80014-3508
Country : US
Telephone Number : 303-999-7763
Fax Number :
Provider Business Practice Location Address
First Line : 400 N TAMPA ST STE 137
Second Line :
City : TAMPA
State : FL
Zip : 33602-4719
Country : US
Telephone Number : 303-999-7763
Fax Number :
Authorized Official
Title or Position : CEO
Name : HANEEN M OMAR
Credential :
Telephone Number : 303-999-7763
Provider Enumeration Date : 10/14/2024
Last Update Date : 10/14/2024

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Directions to “2ND HOME SKILLED CARE SERVICES FLORIDA LLC ” Practice Location

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