MEDICARE: CLOUDS HOME CARE LLC

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1902521925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOUDS HOME CARE LLC

Provider Business Mailing Address
First Line	:	2625 STONEWOOD PARK LOOP STE 112
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-6211
Country	:	US
Telephone Number	:	727-687-2653
Fax Number	:

Provider Business Practice Location Address
First Line	:	2625 STONEWOOD PARK LOOP STE 112
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-6211
Country	:	US
Telephone Number	:	727-687-2653
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ASHLEY KORAH
Credential	:
Telephone Number	:	727-687-2653

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	10/12/2022

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