MEDICARE: AMERICAN CARE OF NORTH FLORIDA, INC

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	174400000X	Specialist	4940	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	K8488	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4940	OTHER	FL	FACILITY LICENSE

General Provider Information

NPI Number	:	1801067517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN CARE OF NORTH FLORIDA, INC

Provider Business Mailing Address
First Line	:	11211 N NEBRASKA AVE
Second Line	:	SUITE A-5
City	:	TAMPA
State	:	FL
Zip	:	33612-5777
Country	:	US
Telephone Number	:	813-514-2333
Fax Number	:	813-514-2216

Provider Business Practice Location Address
First Line	:	11211 N NEBRASKA AVE
Second Line	:	SUITE A-5
City	:	TAMPA
State	:	FL
Zip	:	33612-5777
Country	:	US
Telephone Number	:	813-514-2333
Fax Number	:	813-514-2216

Authorized Official
Title or Position	:	PROVIDER SERVICE MANAGER
Name	:	AGUEDA BOUZA
Credential	:
Telephone Number	:	305-278-0200

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	04/26/2024

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