Organization
MEDERI PRIVATE CARE, LLC
Active
Organization
MEDERI PRIVATE CARE, LLC
Active
Other names
Mederi Private Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L. PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
2815 NW 13TH ST STE 322, GAINESVILLE, FL 32609-2879
(352) 554-8023
(352) 554-8024
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104943900
—
FL
Enumeration date
06/11/2019
Last updated
09/13/2024
Update your record
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