Provider Demographics
NPI:1689286288
Name:FIDELITY HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:FIDELITY HOME HEALTH CARE AGENCY LLC
Other - Org Name:TROPICANO HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:NDIFON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-401-1647
Mailing Address - Street 1:15050 COPPER GROVE BLVD APT 814
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2462
Mailing Address - Country:US
Mailing Address - Phone:281-213-2944
Mailing Address - Fax:281-213-2944
Practice Address - Street 1:20247 CREEKDALE BEND DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7475
Practice Address - Country:US
Practice Address - Phone:281-213-2944
Practice Address - Fax:281-213-2944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care