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General NPI Number Information
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NPI Number | 1205256831
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Entity Type | Organization
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Legal Business Name | CAREPRO LLC
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 4364 S ATLANTIC AVE
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City | PONCE INLET
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State | FL
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Zip | 32127-6939
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Country | US
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Telephone | 386-233-9522
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Fax | 866-236-8577
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Provider Business Mailing Address
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Address Line | PO BOX 290362
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City | PORT ORANGE
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State | FL
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Zip | 32129-0362
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Country | US
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Telephone | 386-233-9522
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Fax | 866-236-8577
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Authorized Official
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Title or Position | CEO
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Name | MR. ROLLEY CLAPP
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Credential |
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Telephone | 386-843-2270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 230417
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License Number State | FL
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