Provider Demographics
NPI:1730562612
Name:SOUTHERN FLORIDA HOMECARE, INC
Entity type:Organization
Organization Name:SOUTHERN FLORIDA HOMECARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:VALCEUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-275-1735
Mailing Address - Street 1:801 NORTHPOINT PKWY
Mailing Address - Street 2:SUITE #30
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1973
Mailing Address - Country:US
Mailing Address - Phone:561-275-1735
Mailing Address - Fax:561-899-6828
Practice Address - Street 1:801 NORTHPOINT PKWY STE 43
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1994
Practice Address - Country:US
Practice Address - Phone:561-275-1735
Practice Address - Fax:561-899-6828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211796251E00000X
FL233794253Z00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care