Provider Demographics
NPI:1407305139
Name:SUNCOAST CARE PROVIDERS INC.
Entity Type:Organization
Organization Name:SUNCOAST CARE PROVIDERS INC.
Other - Org Name:SCP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:ERONINI
Authorized Official - Last Name:NKWOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-431-7176
Mailing Address - Street 1:3104 N. ARMENIA AVE.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1658
Mailing Address - Country:US
Mailing Address - Phone:813-431-7176
Mailing Address - Fax:813-542-2848
Practice Address - Street 1:3104 N. ARMENIA AVE.
Practice Address - Street 2:SUITE 2
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1658
Practice Address - Country:US
Practice Address - Phone:813-431-7176
Practice Address - Fax:813-542-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014068600Medicaid
FL021061300Medicaid