MEDICARE: INTEGRAL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299994469	FL

General Provider Information

NPI Number	:	1003276171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRAL CARE LLC

Provider Business Mailing Address
First Line	:	3401 W CYPRESS ST
Second Line	:	SUITE 202A
City	:	TAMPA
State	:	FL
Zip	:	33607-5019
Country	:	US
Telephone Number	:	813-879-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 W CYPRESS ST
Second Line	:	SUITE 202A
City	:	TAMPA
State	:	FL
Zip	:	33607-5019
Country	:	US
Telephone Number	:	813-879-2273
Fax Number	:

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. MATTHEW KOLINSKI
Credential	:
Telephone Number	:	813-879-2273

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	03/02/2016

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