| Organization Name: | COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC |
| NPI Number: | 1063607489 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLOS JOSE BOSQUE (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 4266 Sunbeam Rd Jacksonville |
| State: | FL US |
| Postal Code: | 322576030 |
| Phone Number: | 9044076231 |
| Fax Number: | 9044076033 |
| NPI Enumeration Date: | 09/10/2007 |
| NPI Last Update Date: | 09/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 5024096 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |