Provider Demographics
NPI:1134127301
Name:BAYCARE HOME CARE, INC.
Entity type:Organization
Organization Name:BAYCARE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMISI
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-470-4609
Mailing Address - Street 1:8452 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5007
Mailing Address - Country:US
Mailing Address - Phone:800-940-5151
Mailing Address - Fax:800-676-3127
Practice Address - Street 1:8020 WOODLAND CENTER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2405
Practice Address - Country:US
Practice Address - Phone:813-806-0700
Practice Address - Fax:813-243-9204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21107096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650975400Medicaid
FL107285Medicare PIN