Provider Demographics
NPI:1578730339
Name:EXPRESS HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:EXPRESS HOME HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-682-2273
Mailing Address - Street 1:4310 S FLORIDA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1631
Mailing Address - Country:US
Mailing Address - Phone:863-682-2273
Mailing Address - Fax:863-682-2275
Practice Address - Street 1:4310 S FLORIDA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1631
Practice Address - Country:US
Practice Address - Phone:863-682-2273
Practice Address - Fax:863-682-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health