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NPI Code Detail

MEDICARE: BAYCARE HOME CARE, INC.

MEDICARE: BAYCARE HOME CARE, 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
1251E00000XHome Health AgencyHHA21070096FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952309171
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYCARE HOME CARE, INC.
Provider Business Mailing Address
First Line : 20 LAKE WIRE DR STE 230
Second Line :
City : LAKELAND
State : FL
Zip : 33815-1566
Country : US
Telephone Number : 863-665-8866
Fax Number : 863-665-8101
Provider Business Practice Location Address
First Line : 20 LAKE WIRE DR STE 230
Second Line :
City : LAKELAND
State : FL
Zip : 33815-1566
Country : US
Telephone Number : 863-665-8866
Fax Number : 863-665-8101
Authorized Official
Title or Position : DIRECTOR
Name : TIMISI C JOHNSON
Credential : RN
Telephone Number : 727-470-4609
Provider Enumeration Date : 07/12/2005
Last Update Date : 06/20/2025

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Directions to “BAYCARE HOME CARE, INC. ” Practice Location

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