Provider Demographics
NPI:1215994637
Name:PHYSICIAN'S CHOICE HOME HEALTH SERVICES,INC
Entity type:Organization
Organization Name:PHYSICIAN'S CHOICE HOME HEALTH SERVICES,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CASELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-946-1920
Mailing Address - Street 1:41 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4304
Mailing Address - Country:US
Mailing Address - Phone:954-946-1920
Mailing Address - Fax:954-946-8338
Practice Address - Street 1:1200 N CENTRAL AVE
Practice Address - Street 2:212
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4450
Practice Address - Country:US
Practice Address - Phone:407-847-2285
Practice Address - Fax:407-847-0285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21773096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHHA21773096OtherSTATE LICENSE
107496Medicare ID - Type Unspecified