Healthcare Provider Details

I. General information

NPI: 1073432027
Provider Name (Legal Business Name): GENTLE CARE COMPANIONS OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10570 S US HIGHWAY 1
PORT SAINT LUCIE FL
34952-5606
US

IV. Provider business mailing address

10570 S US HIGHWAY 1
PORT SAINT LUCIE FL
34952-5606
US

V. Phone/Fax

Practice location:
  • Phone: 772-333-6055
  • Fax:
Mailing address:
  • Phone: 772-333-6055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TAMICA D CLINTON BUSH
Title or Position: ADMINISTRATOR/OWNER
Credential: CLINTON BUSH
Phone: 561-401-5057