MEDICARE: ICARE HOMECARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	305S00000X	Point of Service
2	343900000X	Non-emergency Medical Transport (VAN)
3	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

General Provider Information

NPI Number	:	1699227553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE HOMECARE LLC

Provider Business Mailing Address
First Line	:	16703 EARLY RISER AVE
Second Line	:	SUITE 260
City	:	LAND O' LAKES
State	:	FL
Zip	:	34638
Country	:	US
Telephone Number	:	305-929-3346
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	:	305-929-3346
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATION
Name	:	MYKERA KITCHENS
Credential	:
Telephone Number	:	305-929-3346

Provider Enumeration Date	:	10/26/2016
Last Update Date	:	04/12/2023

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Directions to “ICARE HOMECARE LLC ” Practice Location

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