Healthcare Provider Details

I. General information

NPI: 1275298507
Provider Name (Legal Business Name): QUALITY CAREGIVERS OF TAMPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2021
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N HOWARD AVE
TAMPA FL
33606
US

IV. Provider business mailing address

202 N HOWARD AVE
TAMPA FL
33606
US

V. Phone/Fax

Practice location:
  • Phone: 813-488-5804
  • Fax:
Mailing address:
  • Phone: 813-488-5804
  • Fax: 813-315-6563

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

VIII. Authorized Official

Name: MISS EDNA M GONZALEZ SOTO
Title or Position: OWNER
Credential: ESQ.
Phone: 813-255-8622