Four Nineteen, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

299994641 Issued in FL

Legal business name

FOUR NINETEEN, LLC

Practice address

9015 Town Center Pkwy
#104
Lakewood Ranch, FL 34202-5012

Phone

(941) 920-0826

NPI assigned

Sep 29, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Henry Bernard Haitz III

Title

Owner

Phone

(941) 920-0826

Specialties & licenses 2

Addresses

Other names 1

• Homewatch CareGivers of Lakewood Ranch Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506556800000",
    "number": "1831648930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 TOWN CENTER PKWY",
            "address_2": "#104",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025012",
            "telephone_number": "941-920-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 TOWN CENTER PKWY",
            "address_2": "#104",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025012",
            "telephone_number": "941-920-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR NINETEEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2017-09-28",
        "status": "A",
        "authorized_official_last_name": "HAITZ",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-920-0826",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299994641",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homewatch CareGivers of Lakewood Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin George Fontanini, DOM, AP
• Rylee Foraker
• Colleen Elizabeth Ford, D.C.
• Kristi Jane Ford, APRN
• Damarkco Foster
• Grayson Fox, DC
• Michele Fox, PT, DPT
• Chelsea Floyd Foy, APRN
• Fq0015, LLC
• Free Your Mind Psychiatry, PLLC

• Home Health Agency in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.