Healthcare Provider Details

I. General information

NPI: 1922024355
Provider Name (Legal Business Name): CARE ONE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12220 CORTEZ BLVD
BROOKSVILLE FL
34613-2631
US

IV. Provider business mailing address

12220 CORTEZ BLVD
BROOKSVILLE FL
34613-2631
US

V. Phone/Fax

Practice location:
  • Phone: 352-610-9905
  • Fax: 352-610-9907
Mailing address:
  • Phone: 352-610-9905
  • Fax: 352-610-9907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. STACIE S LAVIANO
Title or Position: MANAGING MEMBER
Credential: APRN
Phone: 352-610-9905