Provider Demographics
NPI:1992710719
Name:SIGHTLINEWORKS, LLC
Entity type:Organization
Organization Name:SIGHTLINEWORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-524-8003
Mailing Address - Street 1:1301 EAST BROWARD BLVD.
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301
Mailing Address - Country:US
Mailing Address - Phone:954-524-8003
Mailing Address - Fax:954-212-3191
Practice Address - Street 1:1301 EAST BROWARD BLVD.
Practice Address - Street 2:SUITE 250
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301
Practice Address - Country:US
Practice Address - Phone:954-524-8003
Practice Address - Fax:954-212-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21600096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650967300Medicaid
107775Medicare UPIN