Healthcare Provider Details

I. General information

NPI: 1316290307
Provider Name (Legal Business Name): ICARE MEDICAL STAFFING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 PGA BOULEVARD SUITE 600
PALM BEACH GARDENS FL
33410-6539
US

IV. Provider business mailing address

4440 PGA BOULEVARD SUITE 600
PALM BEACH GARDENS FL
33410-6539
US

V. Phone/Fax

Practice location:
  • Phone: 561-444-5828
  • Fax:
Mailing address:
  • Phone: 561-444-5828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. AYANNA ROXANNE SUTHERLAND
Title or Position: OWNER
Credential:
Phone: 561-444-5828