Provider Demographics
NPI:1104081876
Name:CARETENDERS VISITING SERVICES OF PINELLAS COUNTY, LLC
Entity type:Organization
Organization Name:CARETENDERS VISITING SERVICES OF PINELLAS COUNTY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PROFFITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-443-4154
Practice Address - Street 1:311 PARK PLACE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-3923
Practice Address - Country:US
Practice Address - Phone:727-584-1824
Practice Address - Fax:727-547-1072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARETENDERS VISITING SERVICES OF PINELLAS COUNTY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-22
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107539Medicare Oscar/Certification