Provider Demographics
NPI:1407293244
Name:TOTAL PRIVATE TAMPA HOME HEALTH INC
Entity Type:Organization
Organization Name:TOTAL PRIVATE TAMPA HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-405-3376
Mailing Address - Street 1:14829 N FLORIDA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1825
Mailing Address - Country:US
Mailing Address - Phone:813-405-3376
Mailing Address - Fax:813-514-0194
Practice Address - Street 1:14829 N FLORIDA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1825
Practice Address - Country:US
Practice Address - Phone:813-405-3376
Practice Address - Fax:813-514-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211543251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health