Healthcare Provider Details

I. General information

NPI: 1477417301
Provider Name (Legal Business Name): CAVIAR CARES HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 TAMPA RD STE 101J
OLDSMAR FL
34677-3223
US

IV. Provider business mailing address

3980 TAMPA RD STE 101J
OLDSMAR FL
34677-3223
US

V. Phone/Fax

Practice location:
  • Phone: 727-340-4469
  • Fax:
Mailing address:
  • Phone: 727-340-4469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: ANGELETA PHIPPS-HARRISON
Title or Position: OWNER
Credential:
Phone: 727-340-4469