Healthcare Provider Details

I. General information

NPI: 1568001451
Provider Name (Legal Business Name): DAVIDSHIELD HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WESTON RD STE 200-2
WESTON FL
33326-3263
US

IV. Provider business mailing address

1500 WESTON RD STE 200-2
WESTON FL
33326-3263
US

V. Phone/Fax

Practice location:
  • Phone: 813-817-8309
  • Fax:
Mailing address:
  • Phone: 813-817-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE LENG
Title or Position: PRESIDENT
Credential:
Phone: 813-817-8309