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NPI Code Detail

MEDICARE: KIDS HOME CARE, INC.

MEDICARE: KIDS HOME CARE, INC.
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1033224753
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS HOME CARE, INC.
Provider Business Mailing Address
First Line : 501 6TH AVE S
Second Line : DEPARTMENT OF MEDICINE
City : ST PETERSBURG
State : FL
Zip : 33701-4634
Country : US
Telephone Number : 727-767-3443
Fax Number : 727-767-8480
Provider Business Practice Location Address
First Line : 12220 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-9201
Country : US
Telephone Number : 813-631-5000
Fax Number : 727-767-8243
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : JUSTIN OLSEN
Credential :
Telephone Number : 727-767-3852
Provider Enumeration Date : 08/21/2006
Last Update Date : 06/21/2024

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