MEDICARE: ETAIROS CARE AT HOME INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HHA299991293	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043257199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETAIROS CARE AT HOME INC

Provider Business Mailing Address
First Line	:	13787 BELCHER RD S STE 220
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33771-4065
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 PALM BEACH LAKES BLVD STE 602
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6505
Country	:	US
Telephone Number	:	561-588-0996
Fax Number	:	561-488-0446

Authorized Official
Title or Position	:	VP REIMBURSEMENT
Name	:	BRETT RAGER
Credential	:
Telephone Number	:	727-614-8300

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	09/27/2021

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