MEDICARE: CARE & BEYOND NURSE REGISTRY

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

General Provider Information

NPI Number	:	1417426107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE & BEYOND NURSE REGISTRY

Provider Business Mailing Address
First Line	:	8049 LAKEPOINTE CT
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322-5767
Country	:	US
Telephone Number	:	954-261-2536
Fax Number	:	954-866-3243

Provider Business Practice Location Address
First Line	:	6280 W SAMPLE RD STE 207B
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-3173
Country	:	US
Telephone Number	:	954-866-3241
Fax Number	:	954-866-3243

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHARON HALL
Credential	:
Telephone Number	:	954-866-3241

Provider Enumeration Date	:	11/25/2018
Last Update Date	:	11/25/2018

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