Provider Demographics
NPI:1689078602
Name:COMPASSION CARE LLC
Entity Type:Organization
Organization Name:COMPASSION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGRANDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-443-0866
Mailing Address - Street 1:4816 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1400
Mailing Address - Country:US
Mailing Address - Phone:813-443-0866
Mailing Address - Fax:813-225-1583
Practice Address - Street 1:4816 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1400
Practice Address - Country:US
Practice Address - Phone:813-443-0866
Practice Address - Fax:813-225-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47234208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherPMC - 1298