MEDICARE: CAREPRO 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	251E00000X	Home Health Agency	230417	FL

General Provider Information

NPI Number	:	1205256831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREPRO LLC

Provider Business Mailing Address
First Line	:	PO BOX 290362
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-0362
Country	:	US
Telephone Number	:	386-233-9522
Fax Number	:	866-236-8577

Provider Business Practice Location Address
First Line	:	4364 S ATLANTIC AVE
Second Line	:
City	:	PONCE INLET
State	:	FL
Zip	:	32127-6939
Country	:	US
Telephone Number	:	386-233-9522
Fax Number	:	866-236-8577

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROLLEY CLAPP
Credential	:
Telephone Number	:	386-843-2270

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	04/22/2014

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