Healthcare Provider Details

I. General information

NPI: 1003078221
Provider Name (Legal Business Name): SPECIALTY CARE ASSISTANCE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2008
Last Update Date: 06/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 WOODMARKER CT
BRANDON FL
33510-2760
US

IV. Provider business mailing address

PO BOX 4256
BRANDON FL
33509-4256
US

V. Phone/Fax

Practice location:
  • Phone: 813-802-6175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number228082
License Number StateFL

VIII. Authorized Official

Name: JOSE ROJAS
Title or Position: PRESIDENT
Credential:
Phone: 813-802-6175