MEDICARE: CARETENDERS VISITING SERVICES OF HERNANDO COUNTY, 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

General Provider Information

NPI Number	:	1093884223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARETENDERS VISITING SERVICES OF HERNANDO COUNTY, LLC

Provider Business Mailing Address
First Line	:	901 HUGH WALLIS RD S
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-2511
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-443-4154

Provider Business Practice Location Address
First Line	:	18118 POWELL RD
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34604-8141
Country	:	US
Telephone Number	:	352-592-1424
Fax Number	:	352-592-1477

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSHUA L PROFFITT
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	09/16/2024

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