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Organization

INTERIM HEALTHCARE OF LEESBURG, LLC

Active
Other names
Interim Healthcare of Gainesville
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KENNETH H. SCHULTZ (CFO)
(407) 645-3211
Entity
Organization

Contact information

Practice address
3760 NW 83RD ST, SUITE 2, GAINESVILLE, FL 32606-6020
(352) 378-0333
(407) 628-2853
Mailing address
1890 STATE ROAD 436, SUITE 300, WINTER PARK, FL 32792-2228
(407) 645-3211
(407) 628-2853

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
20572096
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20572096
STATE LICENSE
FL
Enumeration date
07/27/2012
Last updated
02/08/2016
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