Healthcare Provider Details

I. General information

NPI: 1801067517
Provider Name (Legal Business Name): AMERICAN CARE OF NORTH FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11211 N NEBRASKA AVE SUITE A-5
TAMPA FL
33612-5777
US

IV. Provider business mailing address

11211 N NEBRASKA AVE SUITE A-5
TAMPA FL
33612-5777
US

V. Phone/Fax

Practice location:
  • Phone: 813-514-2333
  • Fax: 813-514-2216
Mailing address:
  • Phone: 813-514-2333
  • Fax: 813-514-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4940
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: AGUEDA BOUZA
Title or Position: PROVIDER SERVICE MANAGER
Credential:
Phone: 305-278-0200