Provider Demographics
NPI:1508069055
Name:SYLVAN HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:SYLVAN HEALTH SYSTEMS LLC
Other - Org Name:SYLVAN HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:727-252-0541
Mailing Address - Street 1:2751 REGENCY OAKS BLVD
Mailing Address - Street 2:SUITE S 105
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1524
Mailing Address - Country:US
Mailing Address - Phone:727-791-1500
Mailing Address - Fax:727-796-8495
Practice Address - Street 1:2751 REGENCY OAKS BLVD
Practice Address - Street 2:SUITE S 105
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1524
Practice Address - Country:US
Practice Address - Phone:727-791-1500
Practice Address - Fax:727-796-8495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991066251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107566Medicare Oscar/Certification