Provider Demographics
NPI:1588821664
Name:VISITING HOMECARE LLC
Entity type:Organization
Organization Name:VISITING HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MMBR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNDORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-574-1622
Mailing Address - Street 1:4880 STACK BLVD STE E5
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-8575
Mailing Address - Country:US
Mailing Address - Phone:321-574-1622
Mailing Address - Fax:321-574-5898
Practice Address - Street 1:4880 STACK BLVD STE E5
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-8575
Practice Address - Country:US
Practice Address - Phone:321-574-1622
Practice Address - Fax:321-574-5898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-17
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health