Provider Demographics
NPI:1992431738
Name:FLORIDA CONCERNED CARE, LLC
Entity type:Organization
Organization Name:FLORIDA CONCERNED CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JERAMIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SNELLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-400-4700
Mailing Address - Street 1:304 S BELCHER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3900
Mailing Address - Country:US
Mailing Address - Phone:727-400-4700
Mailing Address - Fax:727-674-1540
Practice Address - Street 1:8010 WOODLAND CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2419
Practice Address - Country:US
Practice Address - Phone:813-514-4724
Practice Address - Fax:727-674-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020647300Medicaid