Healthcare Provider Details

I. General information

NPI: 1235573403
Provider Name (Legal Business Name): CAREPLUS HOMECARE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 10/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5713 N NEBRASKA AVE
TAMPA FL
33604-7125
US

IV. Provider business mailing address

5713 N NEBRASKA AVE
TAMPA FL
33604-7125
US

V. Phone/Fax

Practice location:
  • Phone: 813-236-4500
  • Fax: 813-236-4505
Mailing address:
  • Phone: 813-236-4500
  • Fax: 813-236-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4299
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number233304
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. SAINT V. PAYEN
Title or Position: ADMINISTRATOR
Credential:
Phone: 813-400-7991