MEDICARE: PUDDLE OF HEARTS HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
3	385H00000X	Respite Care
4	385HR2065X	Child Physical Disabilities Respite Care
5	253Z00000X	In Home Supportive Care Agency

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
2	241309	OTHER	FL	AHCA
3	237556	OTHER	FL	AHCA
4	239897	OTHER	FL	AHCA
5	763	OTHER	FL	AHCA
6	240785	OTHER	FL	AHCA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619546710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUDDLE OF HEARTS HOMECARE LLC

Provider Business Mailing Address
First Line	:	7316 WILDER AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-4270
Country	:	US
Telephone Number	:	904-835-0722
Fax Number	:

Provider Business Practice Location Address
First Line	:	7316 WILDER AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-4270
Country	:	US
Telephone Number	:	904-612-9079
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RAYTONYA FREEMAN
Credential	:
Telephone Number	:	904-835-0722

Provider Enumeration Date	:	06/22/2021
Last Update Date	:	03/23/2026

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Directions to “PUDDLE OF HEARTS HOMECARE LLC ” Practice Location

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