Healthcare Provider Details

I. General information

NPI: 1487283974
Provider Name (Legal Business Name): HEART'S OF SUNCOAST HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 11/25/2023
Certification Date: 11/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 32ND ST
SARASOTA FL
34234-5909
US

IV. Provider business mailing address

1340 32ND ST
SARASOTA FL
34234-5909
US

V. Phone/Fax

Practice location:
  • Phone: 941-879-5499
  • Fax:
Mailing address:
  • Phone: 941-879-5499
  • 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
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY A BUTLER
Title or Position: OWNER
Credential:
Phone: 941-879-5499