Provider Demographics
NPI:1376724146
Name:ALBORADA HOME HEALTH OF TAMPA, INC
Entity Type:Organization
Organization Name:ALBORADA HOME HEALTH OF TAMPA, INC
Other - Org Name:SOUTHEAST HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTAMARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-507-2400
Mailing Address - Street 1:11300 4TH ST N STE 250
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-2918
Mailing Address - Country:US
Mailing Address - Phone:727-546-8900
Mailing Address - Fax:727-546-8940
Practice Address - Street 1:11300 4TH ST N STE 250
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-2918
Practice Address - Country:US
Practice Address - Phone:727-546-8900
Practice Address - Fax:727-546-8940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299992939251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109338Medicare PIN