MEDICARE: ACE HOMECARE 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	212040961	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699025551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE HOMECARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 2261
Second Line	:
City	:	MANGO
State	:	FL
Zip	:	33550-2261
Country	:	US
Telephone Number	:	813-621-0020
Fax Number	:

Provider Business Practice Location Address
First Line	:	4051 N LECANTO HWY
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3551
Country	:	US
Telephone Number	:	352-563-0663
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS COMPLIANCE
Name	:	MS. ROSANNA LALLANA BURKLEY
Credential	:
Telephone Number	:	813-621-0020

Provider Enumeration Date	:	09/18/2012
Last Update Date	:	09/18/2012

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