MEDICARE: ICARE MEDICAL STAFFING, 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
1	385H00000X	Respite Care		FL
2	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1316290307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE MEDICAL STAFFING, INC.

Provider Business Mailing Address
First Line	:	4440 PGA BOULEVARD
Second Line	:	SUITE 600
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6539
Country	:	US
Telephone Number	:	561-444-5828
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 PGA BOULEVARD
Second Line	:	SUITE 600
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6539
Country	:	US
Telephone Number	:	561-444-5828
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. AYANNA ROXANNE SUTHERLAND
Credential	:
Telephone Number	:	561-444-5828

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	10/16/2012

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