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Organization
CLINICAL HOME CARE, INC.
Active
Organization
CLINICAL HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A PANEQUE (PRES OWNER)
(561) 333-0078
Entity
Organization
Contact information
Practice address
11360 FORTUNE CIR, SUITE E29, WELLINGTON, FL 33414-8721
(561) 333-0078
(561) 333-0076
Mailing address
11360 FORTUNE CIR, SUITE E29, WELLINGTON, FL 33414-8778
(561) 333-0078
(561) 333-0076
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
1312795
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R8876
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/31/2006
Last updated
04/20/2008
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