MEDICARE: ALLIANCE JM HOME CARE 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

General Provider Information

NPI Number	:	1083390694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE JM HOME CARE LLC

Provider Business Mailing Address
First Line	:	1704 COTTAGESIDE CT
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33510-2747
Country	:	US
Telephone Number	:	813-377-6774
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 COTTAGESIDE CT
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33510-2747
Country	:	US
Telephone Number	:	813-377-6774
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATION
Name	:	JESUS CASTILLA
Credential	:
Telephone Number	:	813-486-6942

Provider Enumeration Date	:	06/27/2023
Last Update Date	:	08/16/2024

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