Provider Demographics
NPI:1811669898
Name:FIDEM CARE SOLUTIONS, INC
Entity type:Organization
Organization Name:FIDEM CARE SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TASHYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-320-2708
Mailing Address - Street 1:5317 ANHINGA TRL
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-7032
Mailing Address - Country:US
Mailing Address - Phone:727-320-2708
Mailing Address - Fax:
Practice Address - Street 1:5317 ANHINGA TRL
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-7032
Practice Address - Country:US
Practice Address - Phone:727-320-2708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105134100Medicaid