Healthcare Provider Details

I. General information

NPI: 1407501018
Provider Name (Legal Business Name): POLLY'S CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2022
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 SPRING LAKE DR
CLERMONT FL
34711-7987
US

IV. Provider business mailing address

9715 SPRING LAKE DR
CLERMONT FL
34711-7987
US

V. Phone/Fax

Practice location:
  • Phone: 305-733-7981
  • Fax:
Mailing address:
  • Phone: 305-733-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAULINE MORRIS
Title or Position: OWNER
Credential:
Phone: 305-733-7981