MEDICARE: FIRSTONE CARE AGENCY LLC

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	253Z00000X	In Home Supportive Care Agency

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	:	1053953240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRSTONE CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	16350 BRUCE B DOWNS BLVD UNIT 48583
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33646-9105
Country	:	US
Telephone Number	:	813-750-8594
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 MEMORIAL HWY STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-5258
Country	:	US
Telephone Number	:	813-750-8594
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	DAFNY HORICETTE
Credential	:
Telephone Number	:	813-750-8594

Provider Enumeration Date	:	10/09/2019
Last Update Date	:	02/26/2020

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Directions to “FIRSTONE CARE AGENCY LLC ” Practice Location

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