Provider Demographics
NPI:1417672197
Name:HOMEMD HOUSECALL SERVICES FLORIDA
Entity Type:Organization
Organization Name:HOMEMD HOUSECALL SERVICES FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:734-444-9858
Mailing Address - Street 1:5758 COOLEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-3073
Mailing Address - Country:US
Mailing Address - Phone:855-466-3631
Mailing Address - Fax:810-244-0226
Practice Address - Street 1:812 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3338
Practice Address - Country:US
Practice Address - Phone:855-466-3631
Practice Address - Fax:810-244-0226
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITIONAL CARE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric