Organization
CCMEDIC HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDONGESIT E JOSEPH RN (REGISTERED NURSE)
(813) 616-0446
Entity
Organization
Contact information
Practice address
7320 E FLETCHER AVE STE 155, TAMPA, FL 33637-0916
(816) 944-2243
Mailing address
7320 E FLETCHER AVE STE 155, TAMPA, FL 33637-0916
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
05/08/2023
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