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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN MARKHAM (ADMINISTRATOR/AGENT)
(352) 376-4024
Entity
Organization

Contact information

Practice address
4615 NW 53RD AVE, STE C, GAINESVILLE, FL 32653-4885
(352) 376-4024
Mailing address
4615 NW 53RD AVE STE C, GAINESVILLE, FL 32653-4885
(352) 376-4024

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
29993307
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29993307
HOME HEALTH AGENCY LICENSE
FL
Enumeration date
06/26/2013
Last updated
06/26/2013
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