Provider Demographics
NPI:1750071395
Name:TRUECARE OF TAMPABAY CORP
Entity type:Organization
Organization Name:TRUECARE OF TAMPABAY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MS ENG
Authorized Official - Phone:336-473-5797
Mailing Address - Street 1:1692 WINDING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9252
Mailing Address - Country:US
Mailing Address - Phone:336-473-5797
Mailing Address - Fax:
Practice Address - Street 1:1692 WINDING CREEK RD
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-9252
Practice Address - Country:US
Practice Address - Phone:336-473-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299995766OtherAHCA FLORIDA