MEDICARE: PERSONAL CARING L.L.C.

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1508748955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL CARING L.L.C.

Provider Business Mailing Address
First Line	:	3233 NE 34TH ST APT 1006
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6946
Country	:	US
Telephone Number	:	954-383-6389
Fax Number	:

Provider Business Practice Location Address
First Line	:	3233 NE 34TH ST APT 1006
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6946
Country	:	US
Telephone Number	:	954-383-6389
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER, SOLE EMPLOYEE
Name	:	DR. KEVIN PATRICK HANAWAY
Credential	:	DNP, APRN
Telephone Number	:	954-383-6389

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	07/25/2025

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