Provider Demographics
NPI:1215395934
Name:BAHIA HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:BAHIA HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:ORNIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-374-7062
Mailing Address - Street 1:8011 N HIMES AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2700
Mailing Address - Country:US
Mailing Address - Phone:813-374-7062
Mailing Address - Fax:813-433-5363
Practice Address - Street 1:8011 N HIMES AVE STE 1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2700
Practice Address - Country:US
Practice Address - Phone:813-374-7062
Practice Address - Fax:813-433-5363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health