Healthcare Provider Details

I. General information

NPI: 1861363160
Provider Name (Legal Business Name): IVCARE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 13TH ST
SAINT CLOUD FL
34769-4134
US

IV. Provider business mailing address

2801 13TH ST
SAINT CLOUD FL
34769-4134
US

V. Phone/Fax

Practice location:
  • Phone: 407-923-3867
  • Fax: 407-512-5137
Mailing address:
  • Phone: 407-923-3867
  • Fax: 407-512-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHEEJA JACOB
Title or Position: MANAGER
Credential: NP
Phone: 407-923-3867