Healthcare Provider Details

I. General information

NPI: 1700398724
Provider Name (Legal Business Name): EXQUISITE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 07/25/2021
Certification Date: 07/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2261 20TH ST S
ST PETERSBURG FL
33712-3621
US

IV. Provider business mailing address

2261 20TH ST S
ST PETERSBURG FL
33712-3621
US

V. Phone/Fax

Practice location:
  • Phone: 727-453-8974
  • Fax:
Mailing address:
  • Phone: 727-220-9720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number234728
License Number StateFL

VIII. Authorized Official

Name: MRS. MINNIE TERESA LESTER-WILLIAMS
Title or Position: OWNER
Credential: OWNER
Phone: 727-220-9720