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General NPI Number Information
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NPI Number | 1558010587
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Entity Type | Organization
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Legal Business Name | WELCARE OF FLORIDA LLC
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 720 US HWY 441 SUITE 1037
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City | LADY LAKE
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State | FL
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Zip | 32159
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Country | US
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Telephone | 352-505-2191
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Fax |
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Provider Business Mailing Address
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Address Line | 510 CR 466 201 A1
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City | LADY LAKE
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State | FL
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Zip | 32159
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Country | US
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Telephone | 352-728-3012
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEIONTAYE TOLBERT
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Credential |
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Telephone | 404-401-3834
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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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