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General NPI Number Information
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NPI Number | 1699089334
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL CAREGIVER
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 4036 DIAMOND LEAF CT
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City | PALM HARBOR
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State | FL
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Zip | 34684-3610
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Country | US
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Telephone | 727-787-6002
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Fax | 727-787-6002
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Provider Business Mailing Address
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Address Line | 4036 DIAMOND LEAF CT
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City | PALM HARBOR
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State | FL
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Zip | 34684-3610
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Country | US
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Telephone | 727-787-6002
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Fax | 727-787-6002
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Authorized Official
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Title or Position | HOME HEATH AID CNA
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Name | MRS. SUSAN E HOCH
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Credential | H.H.A-C.NA
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Telephone | 727-787-6002
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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 | 199145
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License Number State | FL
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