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NPI Code Detail

MEDICARE: DIVINE HOME CARE

MEDICARE: DIVINE HOME CARE
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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1972462174
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIVINE HOME CARE
Provider Business Mailing Address
First Line : 1500 COLONIAL BLVD STE 205
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1025
Country : US
Telephone Number : 239-270-5193
Fax Number :
Provider Business Practice Location Address
First Line : 1500 COLONIAL BLVD STE 205
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1025
Country : US
Telephone Number : 239-270-5193
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JORGE BERMUDEZ
Credential :
Telephone Number : 305-989-9307
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “DIVINE HOME CARE ” Practice Location

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