MEDICARE: MARY CARES FOR SRQ 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	:	1174412068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY CARES FOR SRQ LLC

Provider Business Mailing Address
First Line	:	10206 MORNING MIST LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34241-1511
Country	:	US
Telephone Number	:	941-587-3285
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 PROFESSIONAL PKWY STE 268
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8457
Country	:	US
Telephone Number	:	239-201-5695
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARY ELIZABETH BENNETT
Credential	:	RPH, CPH
Telephone Number	:	941-587-3285

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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