MEDICARE: NURSECARE, 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	HHA20778096	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	:	1306845912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURSECARE, INC.

Provider Business Mailing Address
First Line	:	837 NE 20TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3035
Country	:	US
Telephone Number	:	954-463-1100
Fax Number	:	954-463-2252

Provider Business Practice Location Address
First Line	:	837 NE 20TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-3035
Country	:	US
Telephone Number	:	954-463-1100
Fax Number	:	954-463-2252

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRADLEY THOMAS DANYLUK
Credential	:
Telephone Number	:	954-463-1100

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	08/22/2020

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