MEDICARE: LMPJL,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	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1912180043
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LMPJL,LLC

Provider Business Mailing Address
First Line	:	7823 N DALE MABRY HWY
Second Line	:	#106
City	:	TAMPA
State	:	FL
Zip	:	33614-3273
Country	:	US
Telephone Number	:	813-514-4724
Fax Number	:	813-514-1495

Provider Business Practice Location Address
First Line	:	7823 N DALE MABRY HWY
Second Line	:	#106
City	:	TAMPA
State	:	FL
Zip	:	33614-3273
Country	:	US
Telephone Number	:	813-514-4724
Fax Number	:	813-514-1495

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. SELMA AUTREY BUDERUS
Credential	:
Telephone Number	:	813-514-4724

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	12/12/2007

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