Provider Demographics
NPI:1609172675
Name:SARASOTA HOME HEALTH CARE AGENCY, LLC.
Entity Type:Organization
Organization Name:SARASOTA HOME HEALTH CARE AGENCY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VISHNEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-306-4347
Mailing Address - Street 1:8051 N TAMIAMI TRL
Mailing Address - Street 2:UNIT #E3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2032
Mailing Address - Country:US
Mailing Address - Phone:941-306-4347
Mailing Address - Fax:941-866-7539
Practice Address - Street 1:8051 N TAMIAMI TRL
Practice Address - Street 2:UNIT #E3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2032
Practice Address - Country:US
Practice Address - Phone:941-306-4347
Practice Address - Fax:941-866-7539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993801251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109793Medicare Oscar/Certification