Organization
FLORIDA WEST HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN D PLOTRIA (PRESIDENT/CEO)
(772) 465-7780
Entity
Organization
Contact information
Practice address
6973 HANCOCK DR, PORT ST LUCIE, FL 34952-8207
(772) 465-7780
(772) 465-7783
Mailing address
6973 HANCOCK DR, PORT ST LUCIE, FL 34952-8207
(772) 465-7780
(772) 465-7783
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
NR30211209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30211209
NURSE REGISTRY
FL
01
—
688636100
MEDICAID WAIVER
FL
01
—
688636101
MEDICAID WAIVER
FL
Enumeration date
07/21/2010
Last updated
09/11/2011
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