Individual provider Active NPI

Latisa Deontary Frazier

  • In Home Supportive Care Agency
  • Lakeland, FL
National Provider Identifier
1063311843
Registry record updated Nov 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
242373 Issued in FL
Practice address
1229 Waterview Blvd E
Lakeland, FL 33801-6749
Phone
(813) 778-9799
NPI assigned
Nov 5, 2026
Last updated
Nov 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 242373 FL Primary

Addresses

Primary practice location

1229 Waterview Blvd E
Lakeland, FL 33801-6749

Mailing address

9340 N 56TH St Ste 110
Temple Terrace, FL 33617-5525
Phone (813) 778-9799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1793836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793836800000",
    "number": "1063311843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9340 N 56TH ST STE 110",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336175525",
            "telephone_number": "813-778-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 WATERVIEW BLVD E",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016749",
            "telephone_number": "813-778-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "LATISA",
        "middle_name": "DEONTARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-11-05",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "242373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.