Healthcare Provider Details

I. General information

NPI: 1932081114
Provider Name (Legal Business Name): OCEAN CARE AGENCY LLC TC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6691 NOB HILL RD STE 102
TAMARAC FL
33321-6405
US

IV. Provider business mailing address

4100 CENTER POINTE DR STE 109
FORT MYERS FL
33916-9460
US

V. Phone/Fax

Practice location:
  • Phone: 239-372-2990
  • Fax: 813-864-0477
Mailing address:
  • Phone:
  • 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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: JENELLE B DAVIS
Title or Position: OWNER
Credential:
Phone: 239-372-2990