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General NPI Number Information
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NPI Number | 1508312216
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Entity Type | Organization
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Legal Business Name | RIVERSIDE CARE OF FLORIDA, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 210 S. PARSONS AVE SUITE 9
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-707-0400
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Fax | 813-322-2362
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Provider Business Mailing Address
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Address Line | 210 S. PARSONS AVE SUITE 9
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 813-707-0400
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Fax | 813-322-2362
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. CASSANDRA VIRGINIA SIMPSON
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Credential | BSN, RN, OCN, CMSRN
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Telephone | 813-707-0400
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 234041
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License Number State | FL
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