Provider Demographics
NPI:1215123062
Name:COMPASSIONATE CARE HOSPICE OF CENTRAL FLORIDA, INC
Entity type:Organization
Organization Name:COMPASSIONATE CARE HOSPICE OF CENTRAL FLORIDA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-2031
Mailing Address - Street 1:3854 AMERICAN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4897
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:212 E HIGHLAND DR STE 105
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1708
Practice Address - Country:US
Practice Address - Phone:863-709-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101553Medicare Oscar/Certification