MEDICARE: MYKERA KITCHENS

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	376J00000X	Homemaker
2	374U00000X	Home Health Aide

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	:	1619498177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYKERA KITCHENS

Provider Business Mailing Address
First Line	:	4205 JORDANA WAY UNIT 124
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34691-6821
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2227 16TH AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33712-2739
Country	:	US
Telephone Number	:	813-330-8387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2017
Last Update Date	:	04/06/2023

Similar Medicare Providers

1699227553 — ICARE HOMECARE LLC
Practice Location Address:

2227 16TH AVE S
ST PETERSBURG, FL
33712-2739

Practice Phone: 305-929-3346
Practice Fax:

1093526303 — YOUR JOURNEY CARE CONNECTION LLC
Practice Location Address:

2205 FERNDALE AVE
PETERSBURG, VA
23803-2739

Practice Phone: 908-887-8746
Practice Fax:

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1881646115 — MS. MELISSA RYAN STRAUSS P.A.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

Directions to “ MYKERA KITCHENS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.