MEDICARE: ELITE COMFORT CARE 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	:	1952197485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE COMFORT CARE LLC

Provider Business Mailing Address
First Line	:	4932 TANYA LEE CIR APT 6206
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-7190
Country	:	US
Telephone Number	:	954-288-3416
Fax Number	:

Provider Business Practice Location Address
First Line	:	4932 TANYA LEE CIR APT 6206
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-7190
Country	:	US
Telephone Number	:	954-288-3416
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	SHAVEL GAYLE
Credential	:
Telephone Number	:	954-200-4125

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	04/21/2025

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