1760576664 NPI number — PHYSICIAN CHOICE HOME HEALTH SERVICES

Table of content: JENNIFER FRANCES CACCIATORE CRNP (NPI 1073028254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760576664 NPI number — PHYSICIAN CHOICE HOME HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICIAN CHOICE HOME HEALTH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760576664
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1129 US HIGHWAY 1 STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKLEDGE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32955-2713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-683-8640
Provider Business Mailing Address Fax Number:
321-609-9059

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 N FEDERAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMPANO BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33062-4304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-946-1920
Provider Business Practice Location Address Fax Number:
954-946-8338
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CASELLA
Authorized Official First Name:
NICHOLA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF FINANCE
Authorized Official Telephone Number:
954-946-1920

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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