Healthcare Provider Details

I. General information

NPI: 1255077350
Provider Name (Legal Business Name): MASTER CARE-GIVERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13806 STATE ROAD 33
GROVELAND FL
34736-9499
US

IV. Provider business mailing address

13806 STATE ROAD 33
GROVELAND FL
34736-9499
US

V. Phone/Fax

Practice location:
  • Phone: 352-874-0639
  • Fax:
Mailing address:
  • Phone: 352-874-0639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ANTHONY BERNARD MCCOY JR.
Title or Position: CEO
Credential:
Phone: 352-874-0639