Provider Demographics
NPI:1295007219
Name:HOME CARE OF TAMPA BAY, LLC
Entity Type:Organization
Organization Name:HOME CARE OF TAMPA BAY, LLC
Other - Org Name:RESIDENTIAL HOME HEALTH OF WC FL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-479-7800
Mailing Address - Street 1:3626 US HIGHWAY 301 N
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-2327
Mailing Address - Country:US
Mailing Address - Phone:941-479-7800
Mailing Address - Fax:941-479-7801
Practice Address - Street 1:1301 10TH ST E STE B
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-4161
Practice Address - Country:US
Practice Address - Phone:941-479-7800
Practice Address - Fax:941-479-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994024251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103172Medicare Oscar/Certification