Provider Demographics
NPI:1629448725
Name:PHILADELPHIA PROFESSIONALS INC
Entity Type:Organization
Organization Name:PHILADELPHIA PROFESSIONALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ODALMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARROSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-873-8117
Mailing Address - Street 1:202 ALLAMANDA DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2928
Mailing Address - Country:US
Mailing Address - Phone:863-333-0650
Mailing Address - Fax:863-583-0421
Practice Address - Street 1:202 ALLAMANDA DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2928
Practice Address - Country:US
Practice Address - Phone:863-333-0650
Practice Address - Fax:863-583-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health