MEDICARE: TACARE HOME HEALTH AGENCY, 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	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1477631448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TACARE HOME HEALTH AGENCY, INC.

Provider Business Mailing Address
First Line	:	2400 W 84TH ST
Second Line	:	SUITE 15
City	:	HIALEAH
State	:	FL
Zip	:	33016-5707
Country	:	US
Telephone Number	:	305-364-9090
Fax Number	:	305-364-9091

Provider Business Practice Location Address
First Line	:	2400 W 84TH ST
Second Line	:	SUITE 15
City	:	HIALEAH
State	:	FL
Zip	:	33016-5707
Country	:	US
Telephone Number	:	305-364-9090
Fax Number	:	305-364-9091

Authorized Official
Title or Position	:	C.E.O.
Name	:	MR. THOMAS CAMPOS
Credential	:
Telephone Number	:	305-364-9090

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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