Provider Demographics
NPI:1306730577
Name:FLORIDA DEC LLC
Entity type:Organization
Organization Name:FLORIDA DEC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:239-837-3374
Mailing Address - Street 1:11181 HEALTH PARK BLVD STE 2265
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-5735
Mailing Address - Country:US
Mailing Address - Phone:219-308-3494
Mailing Address - Fax:
Practice Address - Street 1:11181 HEALTH PARK BLVD STE 2265
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5735
Practice Address - Country:US
Practice Address - Phone:219-308-3494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COOPER HOME HEALTH FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-04
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment