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General NPI Number Information
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NPI Number | 1699227553
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Entity Type | Organization
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Legal Business Name | ICARE HOMECARE LLC
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 2227 16TH AVE S
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City | ST PETERSBURG
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State | FL
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Zip | 33712-2739
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Country | US
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Telephone | 305-929-3346
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Fax |
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Provider Business Mailing Address
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Address Line | 16703 EARLY RISER AVE SUITE 260
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City | LAND O' LAKES
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State | FL
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Zip | 34638
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Country | US
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Telephone | 305-929-3346
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MYKERA KITCHENS
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Credential |
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Telephone | 305-929-3346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 |
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License Number State |
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