Provider Demographics
NPI:1699742783
Name:NORTH CENTRAL FLORIDA HOSPICE, INC.
Entity type:Organization
Organization Name:NORTH CENTRAL FLORIDA HOSPICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:352-378-2121
Mailing Address - Street 1:4200 NW 90TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-3809
Mailing Address - Country:US
Mailing Address - Phone:352-378-2121
Mailing Address - Fax:
Practice Address - Street 1:4200 NW 90TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-3809
Practice Address - Country:US
Practice Address - Phone:352-378-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5023096315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08087519800Medicaid
FL101515Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID