MEDICARE: ANNIES ANGELS HEALTH CARE

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	:	1881902351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNIES ANGELS HEALTH CARE

Provider Business Mailing Address
First Line	:	PO BOX 263543
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33685-3543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9022 N RIVER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33635-9106
Country	:	US
Telephone Number	:	813-380-1658
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FREDA Y GILLESPIE
Credential	:
Telephone Number	:	813-380-1658

Provider Enumeration Date	:	09/18/2010
Last Update Date	:	01/03/2011

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