MEDICARE: ROYALTY CARE SERVICES

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	311Z00000X	Custodial Care Facility		FL

General Provider Information

NPI Number	:	1851585665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY CARE SERVICES

Provider Business Mailing Address
First Line	:	2930 DOWNAN POINT DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7811
Country	:	US
Telephone Number	:	813-920-1424
Fax Number	:	813-852-1263

Provider Business Practice Location Address
First Line	:	2930 DOWNAN POINT DRIVE
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638
Country	:	US
Telephone Number	:	813-920-1424
Fax Number	:	813-852-1263

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LEO RODRIGUEZ
Credential	:
Telephone Number	:	813-951-4802

Provider Enumeration Date	:	09/05/2007
Last Update Date	:	09/05/2007

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