Provider Demographics
NPI:1215384524
Name:SURGICAL HOME HEALTH SPECIALIST
Entity Type:Organization
Organization Name:SURGICAL HOME HEALTH SPECIALIST
Other - Org Name:UNOVA HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-561-6195
Mailing Address - Street 1:913 VENTURE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6695
Mailing Address - Country:US
Mailing Address - Phone:352-801-7284
Mailing Address - Fax:352-801-7398
Practice Address - Street 1:913 VENTURE AVE STE 1
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6695
Practice Address - Country:US
Practice Address - Phone:352-801-7284
Practice Address - Fax:352-801-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health