Provider Demographics
NPI:1174203483
Name:MY BUDDY HOME COMPANIONS CORP
Entity type:Organization
Organization Name:MY BUDDY HOME COMPANIONS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LLANIVI
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-953-9289
Mailing Address - Street 1:7827 LAGO MIST WAY
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4888
Mailing Address - Country:US
Mailing Address - Phone:813-953-9289
Mailing Address - Fax:
Practice Address - Street 1:7827 LAGO MIST WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4888
Practice Address - Country:US
Practice Address - Phone:813-953-9289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care