MEDICARE: CARRIES CARE FAMILY HOME

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1366183840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARRIES CARE FAMILY HOME

Provider Business Mailing Address
First Line	:	1106 E RICHMERE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-8552
Country	:	US
Telephone Number	:	954-534-2904
Fax Number	:	866-305-6709

Provider Business Practice Location Address
First Line	:	1106 E RICHMERE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-8552
Country	:	US
Telephone Number	:	954-534-2904
Fax Number	:	866-305-6709

Authorized Official
Title or Position	:	PROVIDER
Name	:	APRIL THOMAS
Credential	:
Telephone Number	:	954-534-2904

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	04/06/2022

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Directions to “CARRIES CARE FAMILY HOME ” Practice Location

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