Healthcare Provider Details

I. General information

NPI: 1255875159
Provider Name (Legal Business Name): FAMILY FIRST HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13770 58TH ST N STE 317
CLEARWATER FL
33760-3759
US

IV. Provider business mailing address

2203 N LOIS AVE STE 700
TAMPA FL
33607-2387
US

V. Phone/Fax

Practice location:
  • Phone: 727-500-2273
  • Fax: 727-500-2274
Mailing address:
  • Phone: 813-850-0042
  • Fax: 813-850-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: EMMA DE JESUS
Title or Position: CREDENTIALING DIRECTOR
Credential:
Phone: 813-850-0042