Provider Demographics
NPI:1497150544
Name:HOMETEAM PEST DEFENSE
Entity Type:Organization
Organization Name:HOMETEAM PEST DEFENSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YASHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-886-4700
Mailing Address - Street 1:4710 EISENHOWER BLVD STE F3
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6337
Mailing Address - Country:US
Mailing Address - Phone:813-886-4700
Mailing Address - Fax:813-886-1669
Practice Address - Street 1:4710 EISENHOWER BLVD STE F3
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6337
Practice Address - Country:US
Practice Address - Phone:813-886-4700
Practice Address - Fax:813-886-1669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJB164873171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty