Provider Demographics
NPI:1699369967
Name:SAWGRASS HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:SAWGRASS HOMECARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-306-2562
Mailing Address - Street 1:1411 SAWGRASS CORPORATE PKWY STE B50
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2888
Mailing Address - Country:US
Mailing Address - Phone:954-306-2562
Mailing Address - Fax:
Practice Address - Street 1:1411 SAWGRASS CORPORATE PKWY STE B50
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2888
Practice Address - Country:US
Practice Address - Phone:904-318-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL172OtherHOMEWELL CARE SERVICES