Healthcare Provider Details

I. General information

NPI: 1972382810
Provider Name (Legal Business Name): ASSOCIATION HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3632 LAND O LAKES BLVD STE 105
LAND O LAKES FL
34639-4407
US

IV. Provider business mailing address

15101 SOUTHFORK DR
TAMPA FL
33624-2300
US

V. Phone/Fax

Practice location:
  • Phone: 813-919-5555
  • Fax:
Mailing address:
  • Phone: 813-919-5555
  • 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: AMIT SHUKLA
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 240-778-9902