MEDICARE: ISMARTHOMECARE

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1962280636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISMARTHOMECARE

Provider Business Mailing Address
First Line	:	1121 THOMPSON AVE
Second Line	:
City	:	ROSELLE
State	:	NJ
Zip	:	07203-2810
Country	:	US
Telephone Number	:	908-445-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2598 E SUNRISE BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3230
Country	:	US
Telephone Number	:	908-445-1200
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TYWAN DARRELL MATA
Credential	:
Telephone Number	:	908-445-1200

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	02/07/2025

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Directions to “ISMARTHOMECARE ” Practice Location

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