MEDICARE: CARETENDERS OF JACKSONVILLE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist
3	235Z00000X	Speech-Language Pathologist
4	261QR0400X	Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	686855	OTHER	FL	REHAB AGENCY

General Provider Information

NPI Number	:	1376792937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARETENDERS OF JACKSONVILLE LLC

Provider Business Mailing Address
First Line	:	PO BOX 51266
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-1266
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-443-4154

Provider Business Practice Location Address
First Line	:	1101 PLANTATION ISLAND DR S
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32080-6191
Country	:	US
Telephone Number	:	904-815-8157
Fax Number	:	904-376-7624

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

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	01/30/2026

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Directions to “CARETENDERS OF JACKSONVILLE LLC ” Practice Location

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