MEDICARE: SPIRIT ENTERPRISES

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	:	1659642049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPIRIT ENTERPRISES

Provider Business Mailing Address
First Line	:	34213 SPIRIT HILLS WAY
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33523-0630
Country	:	US
Telephone Number	:	352-521-5693
Fax Number	:

Provider Business Practice Location Address
First Line	:	34213 SPIRIT HILLS WAY
Second Line	:
City	:	DADE CITY
State	:	FL
Zip	:	33523-0630
Country	:	US
Telephone Number	:	352-521-5693
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	BEATRICE WHITLEY
Credential	:
Telephone Number	:	352-521-5693

Provider Enumeration Date	:	01/18/2012
Last Update Date	:	01/18/2012

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Directions to “SPIRIT ENTERPRISES ” Practice Location

Language	Start Address	Practice Location

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