MEDICARE: AN ANGELS TOUCH HOMEMAKER COMPANION CARE

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	305R00000X	Preferred Provider Organization	830703	FL

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	:	1740573112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AN ANGELS TOUCH HOMEMAKER COMPANION CARE

Provider Business Mailing Address
First Line	:	2527 ANNAPOLIS WAY APT 109
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-2344
Country	:	US
Telephone Number	:	813-325-5630
Fax Number	:	813-441-8679

Provider Business Practice Location Address
First Line	:	6205 TRAVIS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-5501
Country	:	US
Telephone Number	:	813-325-5630
Fax Number	:	813-441-8679

Authorized Official
Title or Position	:	OWNER.ADMINISTRATOR
Name	:	MRS. YOLANDA MONIQUE MURRELL-HALL
Credential	:
Telephone Number	:	813-325-5630

Provider Enumeration Date	:	05/18/2011
Last Update Date	:	05/15/2019

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